June 26, 2017

12
PSI
CONNECT WITH US
 
 

by Danielle Lim

‘I look at him sitting at the table, between the certificates on his left and the ashes on his right, between the past on his left and the present on his right, between success on his left and brokenness on his right, between the hope of a bright future, on his left, and the courage to keep going, on his right. My uncle. An ordinary man. Some would say an unsuccessful man. Many would say, a mad man. But for me, I will remember him with his smile and the small, beautiful sounds he has echoed into my life.’
.

TWENTY-FOUR years ago, I looked at my uncle as I wrestled with the predicament that his mental illness had put him, and our family, in. The lines above, taken from my memoir, ‘The Sound of SCH’, depict the struggle to make sense of his life after he developed schizophrenia.

When my uncle had a mental breakdown in the 1960s, my grandparents had no idea that he had become unwell. Even when diagnosed much later, treatment at Woodbridge Hospital (the former Institute of Mental Health) was rejected by my grandmother. My mother became his caregiver for the next thirty years, and I spent my growing years watching the loneliness that defined his life, as well as the despair that the circumstances often brought to my mother.

Awareness, treatment and support are better today than during my uncle’s time. Still, the challenges that come when a person crosses from being mentally well to unwell are very daunting. If a word can be associated with this baffling class of illnesses, then that word, to me, is “silence” – the silent onset of illness, the silent suffering of the one afflicted, and the silent despair that family members endure.

You, our readers, are the reason we exist. Your contributions allow us to bring fair and balanced news to everyone, regardless of the ability to donate. Support us by being our patron.

The Silent Onset of Illness

Unlike many forms of physical illnesses, mental illness cannot be seen. The changes in the brain and mind, while often occurring over a period of time, also often occur insidiously. If cancer is called “the silent killer”, perhaps mental illness can be called “the silent destroyer”.

Diagnosis of mental illnesses can be difficult. Psychiatrists I have spoken to have shared that because the human brain is so complex – with a hundred billion neurons and several hundred thousand synapses per neuron – two people with schizophrenia can present with vastly different behaviours and symptoms. There isn’t a precise “test” that doctors can administer to measure the “level” of mental well-being, unlike how we can take a blood sample to measure levels of cholesterol or haemoglobin.

It is usually through changes in behaviour that family or friends start wondering if something is amiss. Yet the amorphous nature of such illnesses often means that the whole process of ascertaining what exactly is amiss can take a while.

 

The Silent Walk Alone

My uncle’s illness took a long time to be discovered when it struck him in his twenties. His life changed completely – he lost his job and friends, became a sweeper, and spent the next thirty years living a lonely life. Yet, he never complained, and was never violent.

Whilst studies show that around 90 per cent of those with mental illnesses do not become violent, there is a general perception that mental illness is associated with violence. There have been steps forward in how mental illness is viewed and treated, and in how recovering patients are supported in their efforts to reintegrate into society. Even so, it may be difficult for us to imagine what it is like to walk the path of a patient.

A doctor once told me that mental illness is the only illness where suicide rates go up when medication starts becoming effective. Therein lies the irony, that when patients become well enough to realise they have a mental illness, they find it such an unbearable sentence that they would rather end their lives.

Schizophrenia strikes about one in a hundred people. Every day, a child is born in Singapore who will suffer from schizophrenia, and the onset of illness is usually between the ages 15 and 30. In other words, it strikes young. I once had a student who was doing well in her studies but who often missed classes, the reasons for which I was not told. I only found out much later about her struggle with mental illness. She probably did not want the people around her to know of her condition. Sadly, such silence typically surrounds the response to having a mental illness.

I know of many who have recovered and who now lead meaningful lives. Recovery is possible, especially with early treatment, and with support from loved ones and the community. Family members, in turn, need support.

 

The Silent Despair of Loved Ones

As Professor Chong Siow Ann mentions in his article “Mental illness: Caregivers are forgotten collateral damage” (The Straits Times, 29 November 2014), the burden of the illness falls not only on the patient, but also on the caregiver and family members. Treatment and recovery can be a long, difficult and uncertain process. The helplessness, anxiety and caregiver stress of loved ones are often overlooked.

Acceptance of the diagnosis is itself difficult. Perhaps because there is still an entrenched social stigma associated with such illnesses, coming to terms with the diagnosis involves an intense inner struggle. How does one accept that one’s spouse or sibling or child is not “normal” and may be seen as “crazy” or “mad” by people around?

After reading my book, a friend told me that her brother had schizophrenia, and that he took his life years ago. She then said, “Please keep this a secret.”

Organisations such as the Caregivers Alliance have been set up to support caregivers of those with mental illness. Such support can make all the difference in enabling caregivers to push on. Many caregivers themselves become depressed, buckling under the weight they have to carry.

My mother did not have such support as she took care of my uncle for over thirty years. At one point, she had to take anti-depressants. I admire her for what she has done, and I salute all caregivers.

Those with mental illness and their loved ones walk a very difficult path. If we can dispel some of the silence surrounding mental illness, perhaps they can stumble a little less on their journey.

.
Danielle Lim is the author of ‘The Sound of SCH: a mental breakdown, a life journey’, a memoir which won the Singapore Literature Prize (non-fiction) 2016.

.
This article is part of a series to shed light on mental illnesses. Read the other piece here:

Taking the Myth out of “Mental” Illnesses

 

Featured image by Sean Chong.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

by Marcus Tan

“MENTAL” illness, for want of a more accurate and less derogatory adjective that allows us to better conceptualise the nature of these conditions, is as old as mankind.

For much of human history, psychiatric conditions were often considered to have supernatural or paranormal origins. Those afflicted were thought to be under the influence of black magic or possessed by evil spirits. Many treatments before the 17th century were based on occult practices that often led to their recipients in a worse off state. As early as the 8th century, the first psychiatric treatment facilities were set up. However, these institutions served more the purpose of containment or confinement. They offered little more than space to contain persons’ behaviours. Treatment, if any, was empirical by large and seldom based on robust medical evidence.

You, our readers, are the reason we exist. Your contributions allow us to bring fair and balanced news to everyone, regardless of the ability to donate. Support us by being our patron.

Psychiatry, as a discipline in medicine, was proposed in 1808 by Professor Johann Christian Riel, a German physician. The word psychiatry itself derives from the two greek words psyche, meaning soul or mind, and iatros, meaning physician. From then, systematic effort, utilising scientific methods was undertaken to study disorders of human behaviour. This pivotal move heralded the development of modern psychiatry. More humane therapies and focus on public education soon followed.

Despite so, there remains much more to be achieved.

Misconceptions about psychiatric conditions and their treatments continue to abound. These range from notions that people with these conditions are “crazy”, “odd”, “bad” or “weak minded” to them never getting well. Despite advancements in treatment, psychotropic medications and even psychotherapy continue to be very much maligned. Medications do not alter personality or rob a person of his / her identity. Apart from a small handful of situations, one cannot be compelled to receive treatment. Psychotherapy is more than “just talk”. Conversation is but an avenue through which rapport is built so treatment can be effected.


What is Psychiatry?

Psychiatry is one of the most, if not the most, misunderstood fields in Medicine. There are few disciplines that have attracted as much controversy.

Misinformation and the consequent misunderstandings about Psychiatry have resulted in the stigmatisation of its receivers of care, the care providers and its practice. More importantly, this stigma has led to apprehension towards help seeking and delay in treatment. Unnecessary, avoidable prolongation of personal physical and emotional distress aside, the individual’s social and occupational functioning are not spared too. With compromised coping abilities, the person can find him/herself overwhelmed by his/her circumstances. These circumstances can be predisposing, precipitating or perpetuating factors that contribute to the origin(s) of illness, which is often multifactorial.

With the world moving at an ever-accelerating pace, most of us already struggle to keep up and can ill afford “down time”. The individual with lesser than usual functional capacity to cope can find him/herself stranded and lost. Unhealthy compensatory or self-help behaviours e.g. harmful addictions or recreational drug use can occur. These behaviours, while offering short term escape, certainly do not help improve the situation in the longer term. A sense of loss of control ensues and ultimately worsens the distress experienced.

Despite emphasis on early help seeking, it is not uncommon in day-to-day clinical practice to have persons come forth to seek help only after long periods of being ill. By this time, it is not unusual for the individual to find that his/her work, relationships, and life have suffered appreciably. These individuals let on that they perceive themselves as “weak minded” and feel shame or even become guilt-ridden in their help seeking. It should not have to be so.

Being distressed is not a sign of weakness. As it has been aptly put, distress occurs only when one has been too strong for too long a time. Only when one has put in his/her best effort, can he/her become exhausted.

Occasional media reporting that sensationalises public displays of behavioural aberrations or suggests an association between criminal or offensive acts and psychiatric conditions do not help. While it is convenient to attribute these behaviours or acts to psychiatric conditions, in reality, these are more related to poorly controlled or untreated symptoms, which arise out of delay in seeking treatment, if there indeed is a presence of an illness in these cases. Ironically, it is not the condition, but the lack of treatment that has led to the outcome. Suffice to say, this misinformation that leads to wrongful association must stop.

Modern Psychiatry

With the advent of technological advances in the 20th  and 21st centuries, physicians have been able to achieve a clearer understanding of the disease process behind some psychiatric conditions and the complex interactions between an individual’s environment and innate factors that result in symptom production. These advances, which include higher resolution brain scans and functional imaging, have also aided the development of medical therapies, while far from ideal, that are safer, more targeted and effective.

At present, it is agreed that a combination of medical, psychological and social therapies are indicated for the treatment of most psychiatric conditions to achieve the best outcomes.

Hence, how do we define modern psychiatry?

Psychiatry is the branch of medicine which is concerned with the understanding, assessment, diagnosis, treatment and prevention of disorders of emotions, behaviour, perceptions and thinking. These disorders predominantly present with behavioural symptoms that occur due to a complex interaction of biological, psychological and social factors. It should not be construed simply as a disease of the mind and/or brain. Treatment is tailored and focused on the person, at times the significant others, within the context of their environment.

We hope that through the course of this series, we can help provide insight into the work healthcare workers do for psychiatric conditions, how assessment is carried out and common psychiatric conditions and their treatments. It is hoped that this information will help bring about better understanding of Psychiatry and promote prompt help seeking. Perhaps you will find out too that psychiatric conditions are not so different from other medical conditions managed by our colleagues in other disciplines.

 

Dr Marcus Tan is a psychiatrist with 18 years of experience in clinical practice in both public and private healthcare. Together with his partners, he runs Singapore’s longest standing community private psychiatric clinic in the heartlands. He also volunteers with the Singapore Armed Forces and serves as a medical assessor on the Medical Board of the Civil Aviation Authority of Singapore. He believes strongly in mental health literacy and sees it as key to improving awareness and decreasing stigma towards psychiatric conditions and persons with them. 

 

Featured image by Sean Chong.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

Bertha in coffee shop

by Bertha Henson

IT BEING the season of Lent, I am going to confess to a sinful act of omission: I stood by while bullying took place. My excuse is that I was restrained by my mother, who shot me a “don’t you dare interfere!” look. So, both of us pretended that we didn’t see or hear what was taking place five metres away from us. Now, this isn’t about a big boy bullying a smaller one or a gang of girls beating up one of their own. This was a maid employer-versus-maid scene taking place in a maid agency.

It’s all too common to see maids “returned” to their agencies because their employers are dissatisfied with their work. The maids are the ones who are teary-eyed with a big suitcase standing in one corner while Mom harangues her or the maid agent.

I have never got used to such sights but this one I witnessed last week took the cake. The screaming Mom emptied out the maid’s suitcase onto the floor. Clothes, slippers, toiletries and underwear spilled out. Her purse was unzipped and coins poured out. The Mom was presumably checking if the maid was taking away anything that was not hers. I thought to myself that she could have done that at home while the maid was packing up.

There were other maids in the shop, waiting for placements, looking on. They kept an absolute silence. As did the maid agents who looked to be in despair over Mom’s antics. And you know what? The Mom had brought her son who looks to be no more than six years old. While she was screaming away, he busied himself eating his packed lunch of chicken rice. But he got up to pick up the coins that had been thrown all over the floor, stacking up the 10 cents and 20 cents for the maid to return to her purse.

I am not sure what the problem was but it had to do with the maid complaining about not getting her eight hours of rest and the Mom responding that she can’t help it if the maid can’t sleep when she’s supposed to. It also had to do with the maid talking back, referring to a Ministry of Manpower booklet on maid rights. Of course, the maid said nothing in the shop. Her face was set in stone in a formidable attempt at self-control but which she quite quickly lost…

The Middle Ground needs your support to continue serving up credible, balanced and independent news. Help us make a difference by being our patron! Thanks!

The maid agent who was talking to the two of us made a concerted attempt to engage our attention during the kerfuffle. It wasn’t very successful. Our ears were otherwise engaged even though we kept our eyes on him.

The maid re-packed her belongings and the Mom proceeded to discuss arrangements with the maid agent, who looked like she’d rather be elsewhere. Then she was off, with son in tow.

It was only then that I burst out in consternation at the humiliation I had witnessed.
Was the Mom trying to show who’s boss? Was she showing her son how a maid should be treated? Didn’t she feel any embarrassment at being such a public spectacle? What a disgraceful human being!

The maid agents agreed that the Mom was “too much” but said there was little they could do with the “customer”.

Whatever wrong the maid had done, no one deserved such a public shaming. I think of her pitiful belongings spread out on the floor and the little boy who was doing his best not to draw attention to himself. I think of how frightened the row of maids must be. What if their next employee was a carbon copy of this particular Mom?

The law isn’t equipped to deal with maid employers who don’t know how to behave like decent human beings. It’s only equipped to deal with those who pinch, punch, slap, scald and starve their maids. I am not asking for the law to intervene in the confines of a home; that would be an invasion of privacy. I am musing aloud at the sort of arrogance some people have and the power they think they wield when they are given the charge of another person’s life.

What would that particular Mom think if her own employer at work dismissed her and swept her belongings from her desk to the floor in full view of her co-workers? I don’t think anyone would stand for such treatment. Even if the victim kept silent, there’s a chance that the co-workers would speak up for her or lodge a quiet complaint to “upstairs”. But we’re talking about foreign maids here who are trying to make a living away from their families and friends.

I am compelled to write this because of the maid who was sentenced to four months jail for “ill-treating” her four year old charge. She had tried to retrieve a medical device from his throat, using her hand and tweezers, and didn’t inform her employers when she couldn’t.

I can just imagine the consternation of the parents when they found out that their boy, who has muscular atrophy and needs support ventilation and oxygen, had been gagging on the plug for hours and turning blue. I can also imagine the terror the maid was feeling about being found out, which would be sooner or later, and being sent packing.

The prosecution asked for 18 months jail term after she pleaded guilty earlier this month, a sentence which District Judge Low Wee Ping had described as “manifestly excessive”. He said that “the system” is at fault for allowing domestic helpers to perform “such medical work”.

“We employ maids too generally. We employ them as car washers, plumbers, house painters, medical caregivers… when we shouldn’t be. And when they do something wrong, we point our (fingers) at them.”

Noting that she had no legal representation, he asked if there was a lawyer in the courtroom who could do the job. Lawyer Mahmood Gaznavi stood up to the plate.

In a later hearing for sentencing on Thursday, Mr Gaznavi described the case as “akin to a specialist carpenter asked to perform complicated mechanical works. She is a person of no skills, let alone skills required to nurse a child who is bedridden.” The maid had two days of instruction on the medical device to suck phlegm from the boy’s throat.

“The accused did not commit the offence out of malice, but out of overzealous attempts to correct an initial act gone wrong,” he said. He distinguished her case from others in which children are deliberately and repeatedly abused by their caregivers.

The prosecution is appealing against the sentence, so not much more can be said about the case. But it’s worth noting that maids cannot be the Jill-of-all-trades in the household. More importantly, they must be treated as human beings who have similar fears and anxieties and who should be accorded the same dignity we expect for ourselves.

People would say that the maid should have told the parents immediately about what happened instead of quaking in silence, just like how I should have intervened in the bullying case.

It’s not comparable, I know.

Except for Mr Gaznavi, nobody behaved very well in this article. My apologies to all maids for the terrible behavior of that particular Mom. Rest assured that not all employers are like her. And dare I say that in the court case, justice was tempered by mercy.

 

Featured image by Sean Chong.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

police car, law and order

by Daniel Yap

THE Singapore Police Force has come under fire of late for how its officers followed Standard Operating Procedures (SOPs) and arrested a 74-year-old woman for her summons over a Town Council fine. The Singapore Prison Service (often and easily confused with the Police) then bound her hand-and-foot to transfer her from custody to a cell.

SOP again, and surely excessive for a geriatric with no criminal past, wanted for putting potted plants in the wrong place. But rules are rules.

But are SOPs rules? Not really. In the army, it is military law that governs us, and then every unit has its standing orders – formally given down the chain of command. An SOP, on the other hand, is simply a set of default reactions and decisions we use when faced with common situations.

Here’s where Robocop steps in to be the hero we deserve, but not the one we really need right now (or is that someone else?). The parable of the police-man-made-machine, and I’m talking about the glorious artistry of the 1987 film, is pit against not just all manner of criminality and pseudo-criminality, but held in contrast against ED-209, the completely robotic but massively powerful law enforcement droid.

ED-209 only reacts to rules and set-in-stone procedures, but Robocop, with the frailty and power of a human mind and emotion, is the hero that saves the day. Our everyday heroes at the Police need to be able to apply Robocop’s humanity, lest they be seen as the cold, marginally vile, by-the-book-only ED-209.

To support TMG, visit our Patreon page. Thanks!

An SOP is a great thing. Like Robocop’s “prime directives”, it saves us the trouble of having to hum and haw excessively over each case. Like Robocop’s targeting computer, it helps speed up our reaction time and decision-making. Like Robocop’s armour plating, it is something to fall back to when things get too complicated or too risky. But SOPs can’t possibly cover every contingency. Things can still go wrong.

Following SOPs does mitigate our actions when things go wrong, but it does not mean that what we did wasn’t wrong. It acts as a reasonable explanation for our chosen actions, but doesn’t absolve us from responsibility.

In other words, the thinking person is not slave to his or her SOPs, and commanders should not teach their charges to become slaves to an SOP. Everyone at all levels of an organisation should be told to think for themselves and then take responsibility for their own decisions.

An SOP is supposed to be a tool that enhances the thinking officer’s effectiveness, not a crutch for mindlessness or a machine to set in motion and forget about. That would make us no better than robots, and in today’s technological world, we really need to differentiate between man and machine, lest our jobs be on the line.

So henceforth let, “we followed procedures” never again be an excuse for not engaging the brain, or doing things with a heart. We’ve got to ask ourselves: what would Robocop do?

 

Featured image from Flickr user Vetatur FumareCC BY-SA 2.0

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

by Bertha Henson

WE’LL all be hearing more from Mr Peter Ho, the former head of Civil Service, because he’s been picked to give the Institute of Policy Studies series of lectures. TODAY ran an interview with him on aspects of the civil service. Perhaps, he could expand on some points he made in his interview when he gives his lectures.
.

1. Mr Ho said that increasing complexity of policies and higher order needs of the populace means coming up with new ways, such as more risk management, to solve problems.

”It’s not that traditional tools are no longer important; tools like cost-benefit analysis are still relevant. But cost-benefit analysis in a complex environment, in and of itself, may not provide you with the complete answer. Cost-benefit analysis is quite linear, and traditional tools don’t help you get your arms completely around complex problems.”

(What traditional tools are less important then? Can he cite instances when the solution did not address the problem because traditional tools were used? Was there a moment of epiphany for him?)

You, our readers, are the reason we exist. Your contributions allow us to bring fair and balanced news to everyone, regardless of the ability to donate. Support us by being our patron.

2. We don’t know when the interview was conducted, whether before or after the Prime Minister said that he didn’t want to be surrounded by naysayers. But clearly, he agrees that the rules-bound culture has to change, going by his message to the younger generation of civil servants.

”Your job is to find ways to improve Singapore’s position and the lot of Singaporeans in a period of accelerating change and uncertainty. Of course, you’re not going to be criticised for following the rules, but if you want to lift the quality of your policies and plans, and raise the level of good governance practised in Singapore, then it cannot be just about saying: “I followed the rules.” Instead, it should be that “I tried to make things better.” The basic misconception some younger civil servants may have is that what worked well in the past will be what propels you into the future successfully. Our civil servants must be able to keep up with the pace of change. You have to ask yourself if the rules, plans and policies still serve the purpose for which they were designed, or if we need to change them in order to do things better. ”

(There’s no point speaking in generalities. Can he enlighten with examples when sticking to the rules is to the detriment of policy outcomes? Or when rules work against the desire of the public service to be emphatic or to “have a heart’’. Can he also tell what rules have been changed because they are no longer relevant. Would policies on single mothers be one of them?)
.

3. Mr Ho talked about the need to be bold which is more difficult now because the basics have been achieved and Singapore is now “competing at the top’’.

”Today, of course, you still want that spark — that ability to think boldly about the future. But the big challenge now is, how much risk are you prepared to take? These are serious risks because we’ve achieved so much, that a bad miscalculation can mean losing it all. The stakes are much higher.”

(Can he give examples of what areas require bold but risky changes? Would the report of the Committee of the Future Economy or the reserved Presidential Election be among them? If so, what are the risks involved? Also, the general perception is the G prefers to make “tweaks’’ rather than take bold steps – or is this the wrong perception?)
.

4. Mr Ho talks about how many ingredients go into making a judgment call.

“…every major decision and every major policy are not an exercise to find the right answers. They are always an exercise in making the right judgment — not a hard right or hard wrong — but a balanced one that serves the best interests of the majority and the country. You cannot make everybody happy. Also, judgments always have to be revisited now and then — to go back to my point that things are changing. What seems to be sensible now may in a few years’ time no longer be sensible. You have to be prepared to constantly change.”

(Again, examples are needed. But there’s another point to consider: The public service shouldn’t think that a change is an acknowledgment of a mistake and therefore paper over the “change’’ as something that is a natural follow through of the old policy. When policies make a sharp turn, the people must be brought on board in understanding the changed circumstances or even objectives. Would he consider that enough explanation was given for the sudden announcement of the increase in the water price? Could Hong Kong’s seizure of the Singapore’s Terrexes be better explained to the people as an example of the changed geo-political realities that Singapore faces?)
.

5. This wasn’t touched upon but hopefully, Mr Ho will pick up the subject in one of his lectures. The civil service has always been accused of “group think’’ with its top echelons being a closed circle of like-minded individuals. That so many top civil servants cross into the political sphere doesn’t add to people’s confidence that radical or bold ideas can surface from the G. One example is how the Committee for the Future Economy is stuffed with Old Economy members. Singapore’s Establishment seems to be a closed rank of people who went to the same schools and move in the same circles with very few gaps allowing for “mavericks’’. Please do not use the sole example of Mr Philip Yeo. He’s just one man.

 

Featured image from Facebook.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

by Bertha Henson

WHO would have thought civil servants would feature so much in the Budget debate? You have MPs who think the system (not civil servants) lack heart and more can be done to improve empathy levels. This, coming after several luminaries, including the Prime Minister, talking about the need for naysayers in the public service rather than people who respond with “three bags full”.

This time, they feature prominently in the debate on the Town Council Amendment Bill, with opposition MPs suggesting that G officials in the Ministry of National Development will be less than neutral over the operations of town councils.

I suppose the mental image that the Workers’ Party has is this: A bunch of civil servants barging into Aljunied-Hougang town council office, rifling through cabinets and accessing computer records because of some suspected wrong-doing on the town council’s part. Or entangling the town council in reams of red tape by asking endless questions because they have oversight powers. And leaving the wards of Ministers alone because, as civil servants, they wouldn’t want to get into the bad books of their political masters.

WP’s Pritam Singh said : “The MND risks becoming a tool of the ruling party of the day to fix the opposition.”

With MND oversight, allegations of partisanship would naturally arise given that a PAP minister is overall in charge. The perception of bias will always be there despite the PAP’s efforts to deny it.

His fellow WP MP Sylvia Lim said: “It is not possible to argue that the ministry is a politically neutral body as recent history unfortunately belies that claim.”

She gave the example of the General Election campaign in 2015, when the Ministry was “an active campaigner against the Workers’ Party, issuing statements practically daily on the alleged misconduct of AHPETC”.

She also said, without elaborating: “To take another example: we have also seen past records of how the Ministry advised a PAP TC how to make good a breach of the Town Councils Financial Rules, quietly behind closed doors, without any media release on the same.”

That is so intriguing.

Of course, the People’s Action Party side came out hammer and tongs accusing the WP of impugning the integrity of the civil service. Senior Minister of State for National Development Desmond Lee had a wonderful quote about how Ms Lim seemed to think that civil servants are “timorous souls” who would “kowtow” to their boss’ bidding.

AHPETC signboard
Aljunied Hougang Punggol East Town Council

No one would dispute that the Act needed updating. The still on-going saga over the finances of the Aljunied-Hougang-Punggol East town council showed up the loopholes on conflict of interest and corporate governance. The G suddenly realised that it couldn’t move on certain things, like order a TC to yield up records and submit information. There was also no “stick” it could wield.

Mr Lee made an interesting point about how AHPETC broke the “unspoken compact” which began when town councils were formed in 1989: That town councillors and elected MPs would proactively fix problems that arise or report suspected misdeeds to the police or Corrupt Practices Investigation Bureau.

In other words, that TCs would “ownself check ownself” just like Ang Mo Kio town council did when it reported its general manager to the police. So if the WP’s finances had been in fine shape, there would be no need for more oversight measures? Hmm.

At the heart of the debate is whether town councils are political bodies. Taken to the bitter political end, MND shouldn’t intervene in a TC’s affairs at all and let residents live with the consequences of their choice. But the G realises that people think it is an administrative issue and expect the G to deal with problems everywhere, including opposition areas.

It’s a tricky balancing act. With MND oversight, allegations of partisanship would naturally arise given that a PAP minister is overall in charge. The perception of bias will always be there despite the PAP’s efforts to deny it.

In fact, it might add fuel to the view that the management of housing estates should go back to the way it was.

According to the feedback given to REACH which had a public consultation process on the Bill, some people had suggested that HDB or MND take over the functions. Or if there must be a regulator, the role could be given to the HDB “so that regulatory decision are one-step removed from political office holders”.

There was also an interesting suggestion that TCs be merged with HDB branch office with chairmen appointed by MND. The elected MPs could form separate committees to guide the work of the new set up to implement infrastructure projects. “This would ensure that the towns are managed fairly, regardless of the party in power.”

Such suggestions, however, would mean unpicking the whole town council structure. It’s like making the elected presidency an appointed office.

I wish that there was a direct response to Ms Lim’s proposal that Auditor-General’s Office could be tasked with auditing town councils on a rotational basis as a substitute for MND’s oversight. There is also her suggestion that an independent Housing Tribunal, chaired by a judge and experts in housing matters, be authorised to mediate and adjudicate disputes relating to the management of public housing.

These are political approaches, of course, to safeguard the independence and autonomy of town councils. They might well be cumbersome and there’s no guarantee that “bias” charge will be overcome.

Do voters really care though?

It’s clear that the WP was tardy and less than transparent about its finances. This might have led to its loss of Punggol East and its shaved margins for Aljunied and Hougang in the 2015 general election. But it can be also argued that if its offences were so egregious as the G makes them out to be, then voters would be moved to eject it altogether. They didn’t.

The amendment Bill actually gives voters less reason to care about who runs their town council. That’s because the law gives the G more powers to supervise, provide oversight and pick up the pieces. Even lift upgrading and replacement are penciled in

HDB residents can really have their cake – and eat it.

 

Featured image by Sean Chong.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

by Bertha Henson

SO THE Attorney-General’s Chambers (AGC) have decided not to appeal against the four-year jail sentence for Joshua Robinson. It has put out a statement to say why: Robinson pleaded guilty which spared the girls the ordeal of going through a trial, the two girls were above 14 which means he did not commit statutory rape, and they had consented to sex.

Not rape. Not outrage of modesty. So the charge against Robinson was sexual penetration of a minor under 16 years of age, which is punishable under section 376A(2) of the Penal Code. The AGC said that this was the most serious charge that the prosecution could have brought on the case. And no, there’s no caning under this clause but a maximum of 10 years jail.

It looks like we weren’t right to say that the girls were sexually assaulted since what he did was not rape nor molest, even though one of them had a mental breakdown after her intimate encounter with Robinson. I suppose the girls were seduced by the American mixed martial arts instructor into consensual sex. Or at least some sexual grooming took place.

You, our readers, are the reason we exist. Your contributions allow us to bring fair and balanced news to everyone, regardless of the ability to donate. Support us by being our patron.

The AGC’s decision isn’t going to please the 26,000 or so people who signed a petition to put Robinson away for longer. It would be quite a wonder, however, if the AGC did appeal. As I said in an earlier column, the AGC would have to concede that it was somehow wrong to ask for a jail-term of four to five years especially since it said it had looked at precedents. Changing its mind and asking for a higher sentence for Robinson means that past offenders had an easier time of it. Recall, for example, the 51 men who charged with having sex with an under-aged prostitute. They were jailed for between four and 20 weeks each.

More importantly, I doubt if the AGC wants to be shown as bowing to popular opinion or “public disquiet”, as Law and Home Affairs Minister K Shanmugam put it.

After all, this would make a mockery of the Administration of Justice Act because outside forces have caused a change of heart. (What’s pretty amazing is that no one in authority has said that it’s wrong to comment on the case given that the appeal limit is not up.)

What would the AGC do the next time there is a public outcry over a punishment that the layman finds inadequate for the crime?

Don’t get me wrong. As far as I’m concerned, Robinson should be castrated whether the girls consented to sex or not. He’s 39, they’re 15. The age gap should have nailed him, as well as filming of the sexual acts. It seems that there are gaps in the law. The AGC said it would be reviewing the law with the Law ministry.

Commenting on this latest announcement, Mr Shanmugam said: “If we don’t think the sentences, based on precedents, are adequate, then we consider what can be done. I do think that the sentences for such offences committed by Robinson need to be relooked at. That is why I have asked my Ministries to study this.”

Well, at least that’s something. It’s good that the AGC did some explaining of the law although I wished it would have said why it agreed to the sentences being run concurrently instead of consecutively.

Maybe, that’s for the judge to decide and written grounds have yet to be made public. It would make for interesting reading.

 

Featured image Earth by Flickr user law-8. CC BY-SA 2.0

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

Someone using the Uber app while a taxi passes by

by Oo Gin Lee

TAXI companies need to understand why users like me who spend about $500-$600 a month on cabs and rides are choosing Uber over taxis. Unless I am in a hurry, I will actually call for an Uber even if I am standing at a cab stand filled with empty cabs.

The biggest problem with cabs are the cab drivers. Many, though not all, are jaded and have bad attitudes. The crux of the problem is that these drivers do not see themselves as service providers which is why they come up with shenanigans like the “changing shift” excuse. Often, “changing shift” is a cover for them to choose the passengers that fits their plans – financially or otherwise. I don’t use Grab either because Grab drivers have the ability to choose passengers – passenger destinations are shown to Grab drivers before they make the pickup.

Uber drivers, on the other hand, do not get to choose their passengers. They only know where their passengers are going after they have picked up the passenger and started the journey.

The Uber system also means that passengers are always able to get a Uber confirmation within seconds, because the booking system does not need to wait for the drivers to make a decision about the rider’s destination. From my experience, when I get a booking with Comfort cab app, the cab arrives in under five minutes. Uber casts the radius wider, so sometimes I have to wait 10 to 15 minutes before the ride arrives. Many Uber drivers are also inexperienced, adding to the late minutes.

Despite this, I still choose Uber because you always get a booking confirmation the fastest (even if it means you still have to wait another 10-15 mins for the car to arrive). The beauty of booking apps is that you can see where the car is and how long more it will take before it reaches you, so you can maximise your time by doing other stuff while waiting for the ride to arrive.

The Middle Ground needs your support to continue serving up credible, balanced and independent news. Help us make a difference by being our patron! Thanks!

The second biggest problem with the taxi business is that the taxi companies act like landlords. Their revenue comes from car rental, which leads to the creation of the two-shift system, where the fairest time to change shift is between 3-5pm. This leads to a shortage of taxis during peak hours, the weakness of the system that private ride companies like Uber and Grab have exploited to the fullest. Ride companies on the other hand, earn by making 10-30 per cent cut of the cost of ride. The difference in the business model explains why you can always get Uber during peak hours. Uber incentivises its drivers to get onto the road during peak hours while taxi drivers are busy putting up their change shift signs and making mental calculations whether the next destination is en route to their handover location.

The third problem is that cabs cost more. Though this isn’t the main reason for me to choose Uber over cabs, I am confident that it is one of the main reasons that even aunties and uncles are choosing to book a ride through Uber and Grab.

So the recent news that the cab companies now want to introduce surge pricing befuddles me. This will drive up revenue for the cab drivers but it won’t solve the three problems why cabs are losing out to Uber. In fact, it will only make it worse. The potential for a more expensive ride does nothing to weed out bad service, and simply makes bad experiences even more unpalatable to customers.

The other problems still remain – customers trying to avoid bad drivers, and cab companies are acting like landlords and not as service providers. And like before, they think they can solve the problem by increasing the “potential revenue” for their drivers, just like when they increased flag-down rates, and introduced new surcharges.

Perhaps in the old days when we didn’t have a choice but to take cabs, this tactic may have worked well enough. But in an age where everybody can be a Uber or Grab driver, or call a car on demand, and at a time when we are hearing stories of cab drivers returning their taxis in droves, this latest initiative to add surge pricing, without first addressing other problems, is surely a recipe for disaster.

 

Oo Gin Lee was a tech journalist for over 15 years before he left The Straits Times in mid-2015 to start his own PR agency that focuses on consumer tech.

 

Featured image by Najeer Yusof.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

Photo By Shawn Danker
A Comfort cab covered in ads trawling the streets of Singapore.

by Bertha Henson

YESTERDAY, my ride from the National University of Singapore in Kent Ridge to my home in the East cost me $51. It was the most expensive fare I’ve ever had to pay in my life.

It was raining. I was carrying books. And I called for a GrabTaxi, none of which was in my vicinity as I could tell from the app. It suggested that I try for a GrabCar as well. Now a standard taxi ride would cost me about $26 to $28, according to the app. A car ride would be a flat $51.

Decision time. Should I pay that high price or hope that a standard taxi would bid? Or should I just stand around in the rain and hope that a taxi with its green light on come by? I went for GrabCar, a Honda Stream, which was due to arrive in three minutes. As luck would have it, I spied a green-lit Comfort cab coming my way. Should I cancel the GrabCar and hop into it? Yet, I also recall the number of times empty cabs have cruised by or drivers who told me that they were not going my way. I also thought about the Grab driver. He would lose his fare.

I let the cab pass.

Now I’m sure people who think I should have hailed the cab would say it’s because I’m “too rich”. I would like to think it was because I’m “too nice”. Serious. Hey, the GrabCar driver could be the family’s sole breadwinner with four schoolgoing children!

Now it seems that surge pricing will come into play in the taxi industry. All the cab companies want some form of demand-and-supply charging system because it seems to be working for rivals, Grab and Uber in terms of incentivising their drivers to stay on their fleet.

The biggest player ComfortDelGro wants to try something in-between – a choice between fixed fare and surge pricing. The fixed fare system, however, doesn’t assure commuters of a guaranteed outcome. The Public Transport Council is looking over the proposal, although I don’t understand why, since fares have been de-regulated since 1998.

The Middle Ground needs your support to continue serving up credible, balanced and independent news. Help us make a difference by being our patron! Thanks!

When canvassed, transport analysts all have something to say about taxi fares. So I thought I should give my take as a passenger too.

a. Cab companies should first get rid of the myriad surcharges it has and streamline fares.

Of course, they should. But they don’t have an incentive to now because nobody hails a taxi and asks for an itemised costing before getting in, like how many ERP gantries the cab would have to pass through and at what cost and whether it’s still peak hour pricing. Cabbies might actually prefer streamlined fares because it saves them from getting into arguments with commuters who accuse them of going “the long way”.

b. Surge pricing might be too heavy a cost for cab companies to carry because unlike their rivals, they don’t have as much money to burn.

I’m no transport analyst, so I don’t know how the change would affect the companies bottomline. But I am a commuter and all I worry about is taxi drivers hiding during non-peak hours and suddenly “surging” during peak hours when fares would be surging too. After all, they already do so now.

c. Surge pricing, if applied to street hailing, would cause confusion for the commuter.

That’s true. A meter system is great because you can actually see the fares going up – and check the cash in your wallet. You can actually stop the cab half-way and get off, which I have done when I think I can save a dollar walking to my destination because my purse is emptying out. Presumably, under the new system, I have to flag a cab down and ask the price – which is given to me. Frankly, my next instinct would be to bargain. Is this allowed? Sigh.

d. Surge pricing may lead to cabbies responding only to calls and avoiding taxi stands.

If you’ve ever been in a taxi queue, you know that feeling you get when a cab comes by to pick up someone who went for a ride-hailing app instead. Sometimes it’s good because it shortens the queue. Sometimes you feel like screaming because the passenger is not in the queue and have therefore “choped” the cab which would have been in the line. I have taken to reading a book while waiting.

Now, what will happen if surge pricing occurs across-the-board. “Unker, how much to Bedok?” “Fifty dollars”. Do you say “No thanks, I’ll take the next ride?” Or do you just get in so as to not lose face with those waiting after you. “Cannot afford, why take taxi?”

At least, the current system is just the booking fee on top of the meter system. You roughly know if you can afford it.

Well, I suppose some would say that surge pricing reflects the true cost of taxi transport. It is, after all, private transport and should not be subsidised.

Don’t you think roads are getting too crowded these days? Those who would have left their cars in carparks are now out picking up fares as Uber or Grab drivers. I think that getting from Point A to Point B is taking much longer than it used to. If the price is too high for too long a ride, public transport would definitely be better value-for-money.

Time to switch mode of transport.

 

Featured image from Shawn Danker.

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250

Featured image by Flickr user Vaping360. (CC BY 2.0)

by Daniel Yap

SENIOR Minister of State for Health Amy Khor’s answer to WP Non-constituency Member of Parliament (NCMP) Leon Perera’s question about heated tobacco products exposed a weakness in the Ministry of Health’s policy on alternative tobacco products, and its approach to science. Smoking is a big risk for our healthcare system, and if alternative products can lower that risk, then perhaps we need to consider them more carefully.

Heat-not-burn tobacco may be strange to Singaporeans because it is banned here, but it accounts for more than five per cent of the tobacco market in Japan after being on the market for just two years, and is catching on in many major markets worldwide. Its popularity is due to rising fears of the effects of second-hand smoke and also smokers’ desire to quit or reduce harm to themselves and their families.

But since Singapore plays host to research and development facilities of tobacco companies, it’s odd to think that we know so little.

How Philip Morris International's iQOS system works
At least we know how Philip Morris International’s heat-not-burn iQOS system works

Plus, since we are at war with diabetes (of which smoking is a major risk factor), it behooves us to be interested in even preliminary studies of products that claim to reduce risks, including e-cigarettes and heat-not-burn products.

I have family and friends who smoke and I would like to know whether this product (or any other, like vaping) could reduce the harm they are doing to their bodies (and to mine). I would think every smoker’s family does.

It takes time, of course, but Dr Khor did not say that studies were underway. Are they? I know the budget is tight, but this is a budget for the future, isn’t it? Why not spend a few million now to potentially reduce future healthcare costs by billions of dollars?

You, our readers, are the reason we exist. Your contributions allow us to bring fair and balanced news to everyone, regardless of the ability to donate. Support us by being our patron.

1. Don’t know means don’t know, not “no”

Dr Khor’s reply sounds like a defence of the G’s policy of banning heat-not-burn products, along with e-cigarettes and non-smoking tobacco. If a lack of information exists for an issue as important as smoking, then it is the duty of the G’s scientists to go and find out more.

If we don’t know, we should be open to trying. I’m not saying we should completely legalise alternative products to all and sundry. Even Mr Perera’s suggestion to start with giving these products to smokers trying to quit will be a start.
.

2. Citing nicotine levels as a reason why heat-not-burn is bad

Mr Perera was asking about the overall risk of heat-not-burn products. Dr Khor answered with how nicotine levels were comparable to regular cigarettes. This answer is strangely off-track.

Smokers are addicted to nicotine but killed by tar and other chemicals. Shouldn’t the answer be about tar and carbon monoxide instead? Or at least one of the many other chemicals in cigarettes that could harm your body?

And if lower levels of other chemicals are detected in heat-not-burn products, then the same level of nicotine would be a good thing because it would be easier for addicts to switch products because they get the same high while causing less harm to themselves and others.

We practise “reduced harm” policies for other vices. If heat-not-burn products and e-cigarettes reduce harm, we should allow them, and the health authorities should commit to this and then go research it.
.

3. Criticise the research, not (just) the researcher.

Dr Khor is a little too dismissive of the research done by tobacco companies when she says “while there have been claims that such tobacco products are less harmful…these claims are made by the tobacco industry”. It is one thing to know that a person or organisation is an interested party in a study or has lied in the past, but that isn’t what makes a study true or untrue.

Research done by tobacco companies on heat-not-burn stretches back to 2008. And it is extensive, with publicly available methodology. Philip Morris, for example, has submitted a two million-page dossier to the US Food and Drug Administration on the effects of heat-not-burn. If heat-not-burn is as harmful as cigarettes, as Dr Khor presumes, then we need to dive into the research, not ignore it.

Since there is currently no research to disprove the tobacco companies, why not peer review their studies? Why not attempt to replicate them? Why not conduct independent studies? That is how one refutes (or proves) another’s research, not by a mere claim that the other party is an interested party. That’s what we do with big pharma, so apply it across the board.

Good science was responsible for linking cancer, diabetes, heart disease and a host of other ailments with smoking. We need to drop the lazy rhetoric and do the hard work of science.
.

4. “There is no safe level of tobacco use”

This was the answer Dr Khor gave to Mr Perera’s query about trialing reduced-risk products to help smokers who have registered for smoking cessation programmes quit.

Not only does it fail to answer Mr Perera’s question, the answer hides behind a truism. Of course there is no safe level of tobacco use. There is also no “safe level” of particulate pollution. There is no safe level of red meat consumption. But we know that a PSI below 50 is considered “healthy”. We know that one can eat a moderate amount of red meat and not be considered “at risk” by doctors or insurers.

We want to know whether heat-not-burn is safer than cigarettes, not whether tobacco is bad for you. Big tobacco is claiming that heat-not-burn is safer. There are no claims that it is safe.
.

5. The “gateway effect” and other “evidence from other countries”

Dr Khor says that “evidence from other countries” shows that heat-not-burn products have emissions that are not too different from cigarettes. However, a November 2016 Ontario Tobacco Research Unit report on heat-not-burn products comes to this conclusion:

“To date, we have not found new independent science that has assessed the harm reduction potential or the acceptability of the current generation of heat-not-burn products… If independent science finds that the new heat-not-burn products do indeed considerably reduce harm and are widely acceptable to smokers, an opportunity would arise for eliminating the sale of the higher risk combustibles.”

So other “evidence from other countries” so far is a well-documented seven-year-long and counting study by UK health authorities disproving Dr Khor’s “gateway effect” fears, and showing the exact opposite.  Dr Khor mentioned the study but didn’t have the time to explain why she didn’t accept its findings.

Instead, her evidence backing up the “gateway effect” is only half a story – that adolescent e-cigarette use in the US is growing quickly (ten-fold since 2011). The other side of the story, which she left out, is that there was a sharp decline in conventional cigarette use over the same period. I’ll not be one to confuse cause and correlation, but telling only one side of the story robs us of the facts.

Add to that the fact that the UK government has concluded that e-cigarettes are definitely less harmful than regular cigarettes and you’ve got to ask: Could the Ministry of Health, in their over-zeal to protect Singaporeans from “potential harm”, also be holding us back from potential benefits? All I know is that we can’t justify our policy positions with bad, bad science.

 

Featured image by Flickr user Vaping360. (CC BY 2.0)

If you like this article, Like The Middle Ground‘s Facebook Page as well!

For breaking news, you can talk to us via email.

 

skillsfuture_300x250