Louis asked the Minister for Manpower whether the Ministry will consider requiring immediate reporting by doctors to the Ministry of work injuries that require 24 or more hours of hospitalisation or when three or more days of medical leave is required, considering that the current system relying on employers to report voluntarily may lead to the under-reporting of injuries.

Mr Teo Ser Luck (for the Minister for Manpower): Madam, under the Workplace Safety and Health Act and Work Injury Compensation Act, it is mandatory and not voluntary, for employers to report any work-related accident resulting in an employee's death, or hospitalisation for at least 24 hours, or medical leave for more than three days.

It is an offence for employers not to notify MOM of the reportable accidents. MOM has taken enforcement actions against errant employers for persistent late reporting of minor injuries after repeated reminders, or delayed reporting of a serious work injury. Since 2014, seven such employers were taken to task.

Currently, injured employees, their dependents and representatives as well as doctors can submit an incident report directly to MOM online or in person if they are concerned that the employer may not report the accident. However, I would like to emphasise again that the primary responsibility to report accidents should rightfully rest with the employer.

Louis: I thank Minister of State for the reply. I have two clarifications. One, from 2010 to 2011, the number of reported cases of Occupational Diseases (OD) already almost doubled from 432 cases to 839. As MOM noted, this rise was primarily due to efforts to address potential under reporting. Specifically, MOM had been engaging medical practitioners to encourage them to report ODs. Can the Minister of State clarify whether the under reporting for OD previously, would be the same for the work injuries?

I asked this PQ because the Minister of State has stated more accurate reporting will aid better analysis of workplace health issues, so that we can better address concerns holistically. I also understand that there are concerns of administrative burden to the doctors. Can the Minister of State clarify whether the doctors can also use the "iReport" which they currently use to report ODs, for work injuries as well? 

Mr Teo Ser Luck: I thank the Member for the supplementary question. Currently, the employers are still primarily responsible for ensuring the safety and health of their employees at work. They are required to report any work related injuries or Occupational Disease when the reporting conditions are met. They should be promptly notified and be involved in the investigation process as well. But unlike injuries, the onset of the Occupational Disease, as the Member has stated, is usually gradual and in some instances, the victim may have changed employers or the workplace may have ceased to exist.

Hence, it could be difficult for the employer to detect and be aware of an Occupational Disease under such circumstances. Therefore, we require the doctors to report Occupational Diseases to give us a better picture of the occupational health situation. This is an approach that is similar to countries such as Germany, Denmark and Hong Kong. More than 95% of the cases for injuries that MOM sees are reported by employers today. This is a relatively high compliance. We will continue to monitor closely before taking further action or impose further requirements on the doctors. And yes, they can use the "iReport".

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Manpower (a) what is the number of workplace injuries reported in the past five years; and (b) whether the Ministry will consider adopting a system of workplace injury reporting based on (i) diagnosis of a specified list of common work-related injuries requiring medical treatment and (ii) requirement of treatment in a hospital without any time threshold such as used in the US (Occupational Safety and Health Act of 1970), Australia (Occupational Health and Safety Act 2004) and the UK (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013).

Mr Sam Tan Chin Siong (for the Minister for Manpower): Sir, under the Workplace Safety and Health (Incident Reporting) Regulations, it is mandatory for employers to report work-related accidents where the employee was given more than three days of sick leave, or hospitalised for at least 24 hours. In the last five years, an average of about 12,800 such workplace injuries were reported to MOM every year. The number has been stable over this period.

Our reporting criteria are aligned to international practices which focus on reporting injuries that are more serious. In fact, ours is similar to that of the European Agency for Safety and Health at Work (EU-OSHA). This EU regulation also requires reporting of any injury that results in more than three days of sick leave. The reporting regimes in other countries also do not require all injuries to be reported. For example in the UK, beyond the prescribed list of reportable injuries, such as fractures, amputations, burns or blindness, all other injuries are only reportable if the sick leave is seven days or more. Hence, our reporting regime of three days or more is actually more robust. The UK also requires the injury to be reportable if it results in hospitalisation for more than 24 hours, which is similar to our reporting regime.

Our incident reporting criteria of more than three days' sick leave and hospitalisation for more than 24 hours would already cover the more serious injuries that other jurisdictions deem reportable. Hence, our regime is comparable and equally robust as the other developed countries.

Louis: I thank the Minister of State for the response. I just have two supplementary questions.

How does MOM know whether there is currently under-reporting of workplace injuries? Second, has MOM come across cases where doctors issue less than three days of medical certificate (MC), so that the employer does not need to report the work injury to MOM, and what steps MOM will be taking to address this? 

Mr Sam Tan Chin Siong: Mr Speaker, Sir, I thank the Member for the two supplementary questions.

First, on the under-reporting. We have been monitoring the workplace injuries reporting since the scheme was revised in 2014. Our assessment and observation, and also through our contacts with the companies and workers, suggest that there is no evidence of widespread under-reporting. But, of course, we cannot assume that there will not be any under-reporting. But our assessment is under-reporting is still constituting the minority.

In any way, under our regime, even if the employers do not report any workplace incidents, the workers themselves can approach and report the injuries or incidents to MOM. For cases that are reported to MOM, we will take a look at the situation and then we will take appropriate actions. In the last one year, there were close to 1,900 workers who report their injuries directly to MOM because they were not so sure whether their employers had made a report. So, within our system, there is already a regime and also a discipline where we can ensure that the workers can report on their injuries even if their employers do not.

As for the Member's second supplementary question, the issue has been addressed in 2014 when we reviewed and revised our incident reporting regime. In 2014, we had decided and we had changed the regulation to ensure that even if a doctor gives two days of MC and then have a break in between, and then issue another two days of MC and so on, MOM will still deem all these injuries or MCs as reportable incidents, so long as the accumulative MCs is three days or more.

If any doctors are found to have adopted this practice of issuing two days of MC, then have a break of one day in between, and then issue another one or two days of MC, if we come across such cases, we will investigate. And if it is a practice for the employers to avoid reporting the incidents to MOM, we will refer the doctors to the Singapore Medical Council for follow-up actions. 

Louis: Can I ask the Minister of State when is the next time this regulation is going to be reviewed? And during that review, whether MOM will consider adopting a system of workplace injury reporting similar to those of the US, UK and Australia? 

Mr Sam Tan Chin Siong: I thank the Member for the further supplementary question. As I mentioned just now, the Workplace Safety and Health Incident Reporting regulation was reviewed in 2014, which is about three years ago. We have been monitoring the implementation of this revised scheme and we have found it to be working quite well so far.

But of course, as a policy matter, policy review is always a work in progress. We will continue to review and monitor the situation. If there is a need to further review it in the future, we will certainly do so. When we conduct the next review, we will certainly take reference from international best practices including the countries mentioned by the Member – the UK, US, Australia and so on. We will study them together with other countries' best practices. We will adopt the most relevant, practicable and reasonable ones to be incorporated and further strengthen our reporting regime. 

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Manpower (a) to date, how many companies have adopted the SnapSAFE app for reporting of workplace safety issues; (b) how many complaints have been filed through the app in 2015, 2016, 2017 respectively; (c) what is the breakdown of valid and invalid reports; (d) how many companies have been reported; (e) how many employers have been disciplined for unsafe work practices in 2015, 2016 and 2017 respectively; and (f) what actions have been taken against them.

Mr Lim Swee Say (MOM): The number of reports received via the Snap@MOM app, number of valid reports, and number of companies issued with enforcement actions between 2015 and 2017 is shown below: -

All valid reports have resulted in warnings or enforcement actions. The enforcement actions included Notices of Non-compliance, composition fines and/or Stop Work Orders.

The Snap@MOM app was enhanced and replaced by the SnapSAFE app on 1 December 2017. It has a new internal corporate reporting function for in-house reporting of WSH lapses, near-misses or accidents to facilitate company ownership on WSH. As it is in its initial months of launch, we are currently reaching out to more companies to adopt this as an internal WSH reporting tool.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Manpower (a) how our rates per 100,000 employed persons in Singapore for (i) minor workplace injury (ii) major workplace injury and (iii) death, compare with other countries who also base their reporting criteria on that of the European Agency for Safety and Health at Work (EU-OSHA); and (b) what would be the possible factors for the difference if there is a significant discrepancy for those rates.

Mrs Josephine Teo (MOM): Both Singapore and the European Agency for Safety and Health at Work (EU-OSHA) require reporting of injuries that result in more than three days of medical leave. In addition, Singapore also requires reporting of injuries that result in at least 24 hours of hospitalisation.

Singapore attained a workplace fatal injury rate of 1.2 per 100,000 employed persons in 2017. This was lower than the average fatal injury rate of 1.7 per 100,000 employed persons among EU countries that use EU-OSHA's reporting criteria.

EU-OSHA does not publish minor or major injury data, but does so for non-fatal injuries as a whole. Singapore had a non-fatal injury rate of 368 per 100,000 employed persons in 2017, compared to the EU-OSHA average of 1,586 per 100,000 employed persons. 

We should, however, be cautious in comparing our non-fatal injury rate with that of the EU. While Singapore and EU-OSHA apply the same threshold of medical leave duration for reporting purposes, differences in data collection systems may account for some variations. EU countries with higher non-fatal injury rates generally draw injury data from insurance claims, while those with lower rates generally rely on injury reporting by employers. 

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Manpower whether the requirement for reporting work-related or workplace accidents can also include cases where an employee who meets with an accident is placed on light duty by the doctor for more than three days, whether consecutive or not.

Mr Zaqy Mohamad (for the Minister for Manpower): Mr Speaker, today, reporting is required for all work injuries resulting in medical leave of more than three days, consecutive or otherwise, or hospitalisation for at least 24 hours. This is in line with the reporting criteria in other developed countries, such as those in the European Union.

We are studying the possibility of making it a requirement to report all work injuries resulting in any instance of light duty or medical leave. This has been included in the public consultation on amendments to the Work Injury Compensation Act (WICA) which was launched just this year in January. It will allow us to have a more comprehensive picture of the extent of work injuries and will help improve targeting of prevention efforts. We will share more details when the proposed amendments to WICA are finalised this coming April.

Louis: Sir, I thank the Minister of State for the reply. Can I just confirm we are having a list of specified injuring similar to what the UK has, which is that regardless of the number of medical certificates (MCs) or number of days of light duty, mandatory reporting is required?

The second clarification is whether we can follow what we do for occupational diseases where it is the doctor that reports the occupational diseases rather than the employers, that is, whether the doctors will in the future do reporting for work-related accidents rather than the employers.

Mr Zaqy Mohamad: At this moment, what I can commit is that we are looking at all forms of injuries that result in light duty medical leave. Specific to the list in the UK, I cannot confirm right now. But may I suggest that the Member submits another Parliamentary Question so that we can make a comparison. I have not done a comparison for this particular Parliamentary Question but, generally, all work injuries that result in light duty medical leave will be covered in the new WICA Act, subject to some of the consultation exercises that we are having.

The second question was with regard to the practice with doctors. That is to be further studied. Let us take it up with MOH to study this.

Source: Hansard (Parliament of Singapore)

Guidelines on Disability Duration for Specific Injuries for Doctors

Louis asked the Minister for Health whether the Ministry will consider issuing guidelines on disability duration for specific injuries for the use of doctors issuing medical leave and light duties for injured workers returning to work.

Dr Lam Pin Min (for the Minister for Health): Mr Speaker, in assessing the need for a medical certificate and its duration, both medical conditions and non medical circumstances need to be considered. These include the type and severity of the medical condition or injury; time needed for the treatment, rehabilitation and recovery; and work requirements and workplace conditions. The circumstances vary widely among different persons, making it difficult to come up with prescriptive guidelines.

The attending doctor should use his or her professional judgement, and when in doubt, consult fellow peers on what is needed to help the patient recover from a medical condition or injury. 

To guide this, the SMC revised the Ethical Code which came into effect in 2017. This provides broad guidelines that medical certificates must be issued to patients on proper medical grounds arrived at through good clinical assessment, and doctors must not take into consideration extraneous factors such as who pays for the consultation, what benefits the patients may receive or what employers’ preferences may be. Also, when certifying that patients are fit to return to work but with limitations on their level of activity at work, doctors must first ensure that the patients’ work conditions allow this and, to the best of their ability, ensure that appropriate light duties are in fact available to the patients at their place of work.

MOH will study if it is necessary to formulate specific guidance in particular settings and seek inputs from the professional bodies.

Louis: I thank the Senior Minister of State for the reply. I just wanted to check the last part. He said that MOH is going to study this issue. Is it going to conduct a review on whether we can set up more specific guidelines, rather than the broad guidelines we have in our code now?

Secondly, I am asking this in relation to the recent case where the doctor issued two days of light duty for the worker that had a broken collar bone. So, how does MOH ensure that the appropriate number of medical leave or light duty is issued after a surgery or after a work-related accident?

Dr Lam Pin Min: Mr Speaker, as alluded to in my reply, there are already existing broad guidelines issued by SMC in their ethical code which gives some guidance to doctors on what is expected of them. With regard to whether we will come up with any specific guidance, this is an area where we will consult professional bodies to study whether it is feasible or practical to even do so. However, if the professional bodies think that there may be scope to provide some kind of guidance for certain types of injury, we will take their advice into consideration.

With regards to Mr Louis Ng's other question about the duration of Medical Certificates (MCs), this question had also been raised in the last parliamentary sitting by the Member, where a question was posed to MOM about whether MOM will be studying ways to better support the injured workers. MOM has already given the reply that they are currently reviewing it and will be conducting public consultation on this issue.

Source: Hansard (Parliament of Singapore)

Claims under Work Injury Compensation Act by S Pass and Work Permit Holders in Last Three Years

Louis asked the Minister for Manpower in the last three years, what percentage of claims under the Work Injury Compensation Act made by S Pass and Work Permit holders are determined to be valid or invalid within (i) one month (ii) three months (iii) six months and (iv) longer than six months from the accident respectively.

Mrs Josephine Teo (MOM): Investigation on the validity of a work injury claim starts after we have received an incident report from the employee or his representatives.

In 2018, 70% of the claims by S Pass and Work Permit Holders were determined to be valid or not within one month. For the remaining claims, determining validity took a longer time because of delays due to various parties.

Common reasons for delays include incomplete information provided by the injured employee, difficulty in locating and getting witnesses to come forward, and having to wait for medical assessments of whether an injury occurred or not, in cases where injuries were not visible.

For cases that took more than six months, they are mainly due to fraudulent claims investigation. These cases are complex and we want to conclusively establish whether they were work injuries, rather than prematurely ruling them as valid or invalid.

Source: Hansard (Parliament of Singapore)

Most Common Methods Used by Employers to Avoid Reporting Work-related Injuries

Louis asked the Minister for Manpower (a) what are the most common methods used by employers to avoid reporting a work-related injury; and (b) what are the most common ways that instances of non-reporting of work-related injuries by employers are detected.

Mrs Josephine Teo (MOM): Today, employers are required to report work injuries resulting in medical leave of more than 3 days, hospitalisation for at least 24 hours or death.

Common reasons cited for delayed or non-reporting are (i) the employer did not agree that the injury was work-related; and (ii) the employee did not inform the employer of the work injury.

Non-reporting of work injuries by employers are usually detected when an employee or his representative files an incident report to MOM.

Source: Hansard (Parliament of Singapore)

Occupational Injury Cases Seen by Private vis-à-vis Restructured Healthcare Providers

Louis asked the Minister for Manpower (a) what is the current percentage of work injuries or occupational injury cases that are seen by private compared to restructured healthcare providers; and (b) what are the patterns (types of injuries, severity of injuries, sectors, occupations) seen by private compared to those seen by restructured healthcare providers.

Mrs Josephine Teo (MOM): In the past three years, around 75% of work injury cases have been seen by public healthcare institutions, while the remaining 25% have been seen by private healthcare providers.

The industry and occupation profile of injured workers seen by the public healthcare institutions and private healthcare providers are similar.

Nonetheless, a larger proportion of the cases handled by the public healthcare institutions involve serious injuries such as fractures, dislocations and crushing injuries, compared to the private healthcare providers. Correspondingly, private healthcare providers have a larger proportion of less serious cases, such as bruises and sprains, compared to public healthcare institutions.

Source: Hansard (Parliament of Singapore)

Employers Prosecuted for Failure to Report Work-related Injuries

Louis asked the Minister for Manpower in each of the past five years (a) how many employers have been prosecuted for failing to report a work-related injury; and (b) how many of these employers who failed to report a work-related injury have been punished with a fine and how many have been punished with imprisonment.

Mrs Josephine Teo (MOM): Non-reporting occurs mostly because employers disputed that the injury was work-related, or was not informed of the injury. Before 2018, we focused on educating employers to have better systems to detect and surface injuries suffered by their employees, and to report injuries brought to their attention even if they believe the injuries were not work-related. Since the start of 2018, we have stepped up our enforcement efforts which led to an increase in the number of employers being taken to task for non-reporting.

In addition to the 40 composition fine cases, a site manager was convicted in 2016 for attempting to cover up a workplace accident by abandoning the injured worker along an alley. The manager was jailed six months for the offence. There has been no other case of non-reporting which resulted in imprisonment.

Source: Hansard (Parliament of Singapore)

Louis delivered the following speech in support for Work Injury Compensation Bill.

Louis: Sir, I stand in support of the Bill. We have made great strides in prioritising workplace safety and health (WSH). Our WSH 2028 strategy articulates a Vision Zero for all stakeholders to work towards preventing all forms of injury and ill-health at work.

While we work towards the WSH 2028 vision, the work injury compensation regime provides a safeguard for employees who unfortunately have suffered a workplace injury. In this distressing period, work injury compensation helps to alleviate some of the financial burden on employees and to ensure that they have access to the necessary medical treatment.  

The Bill proposes an overhaul of the existing work injury compensation regime which on the whole benefits both employees and employers by expanding WICA coverage, licensing WIC insurers, and simplifying and expediting work injury claims processes. I applaud the ambitions of the Bill. 

I have the following clarifications and recommendations on how the proposed amendments will be implemented in Subsidiary Legislation and operational policy.

The problem of some doctors giving insufficient medical leave to migrant workers has been a recurring problem for several years. I would like to highlight two recent cases where doctors were suspended by the High Court for professional misconduct.

In the first case, Dr Kevin Yip gave two days of medical leave and light duties thereafter to Mr Zhang, a construction worker, despite the latter having a serious fall that resulted in multiple injuries such as a fractured collarbone and a few rib fractures. In the second case, Dr Wong Him Choon likewise gave two days of medical leave and light duties thereafter to Mr Fan, also a construction worker, despite the latter sustaining hand and forearm fractures that required surgery after a fall from height. 

Errant employers may influence medical practitioners to prescribe lesser days of medical leave and provide light duties in order to downplay the severity of an injury or to avoid reporting the accident.

 I previously asked the Ministry whether the requirement for reporting work-related or workplace accidents can include cases where the employee is placed on light duties. I understand that the reporting requirements for a workplace accident will be updated in Subsidiary Legislation. The criteria for reporting an injury will now be at least 24 hours of hospitalisation or any instance of medical leave or light duties. 

This will help address cases of doctors under-prescribing medical leave to employees so that employers can avoid reporting an accident. I thank the Ministry for taking this step. 

However, my concern is that doctors may now circumvent this requirement by not prescribing any medical leave or light duties at all. The Ministry has stated that the Singapore Medical Council (SMC) has mechanisms to take disciplinary action against doctors who do so. However, this requires a process of detection, investigation and enforcement. The employee who has suffered a work injury may be denied access to medical documentation, proper and timely medical treatment and compensation in the meantime. 

How will the Ministry monitor incidences of medical malpractices by doctors under the new reporting requirements? 

Further, will the Ministry consider implementing a dual reporting system by both doctors and employers in the future? 

Next, the Bill also extends compensation coverage to employees on light duties. This is welcome as it is now very common for injured employees to be prescribed light duties in lieu of medical leave. 

However, I understand that there is a lot of confusion on the ground as to what constitutes light duties and when an injured employee can be prescribed light duties. The SMC Ethical Code and Guidelines require doctors to ensure that there are appropriate light duties available to the employee at their work places before prescribing light duties. In practice, I understand that many doctors prescribe light duties when in fact there are no light duties available at the workplace. This leads to confusion for both the employees and the employers. There are stories of employees who end up not working at all or employees who do heavy labour that is inappropriate for their physical conditions.  

I appreciate that this is an issue that will have to involve the Ministry of Health, SMC and doctors and return-to-work occupational therapists. Given that light duties are now more significant under the work injury compensation regime, will the Ministry work with the relevant stakeholders to shed more light on what constitutes light duties and when it can be prescribed? 

Next, the Ministry has also stated that employees will receive notice of accident reports after they have been submitted to the Ministry. The amendments will also introduce an automatic claim application system for fatal or serious injuries. The accident report and claim application state important details such as the location of the accident, the nature of the injury, and the Average Monthly Earnings (AME). These are key details that will affect the compensation assessment. 

Can MOM confirm that the employee will receive notice of the accident report and claim application in all cases? Will the employee be given the opportunity to challenge the details stated in the accident report and claim application where filed by the employee or automatically processed? 

Further, can the MOM share how it intends to ensure that the accident report and claim application will reach the hands of a migrant worker whose address is likely to be the office address of their employer? Can the accident report and claim application be sent to the migrant worker through existing mobile applications? Alternatively, do employees have the right to obtain copies of these documents directly from MOM free of charge? 

Next, the Bill proposes for licensed insurers to process insured WICA claims. I hope this move will help to expedite the claims process and ensure timely payouts for employees. I have two points relating to processing of claims by insurers. 

First, can the licensing regime for insurers also include a requirement that insured employees be issued with insurance cards to facilitate faster processing of medical appointments and procedures? I understand that injured employees are sometimes caught in limbo where their employer has not paid for medical treatment and refuses to provide a Letter of Guarantee for the necessary medical procedures. Requiring that employees hold insurance cards not only benefits, it will also take some of the burden off employers and reduce the amount of bad debt hospitals face due to unpaid medical bills by employers. 

Secondly, to facilitate the insurance payouts, can the Ministry assist injured migrant workers who do not have bank accounts in opening one? I understand that MOM can issue a letter to help migrant workers open a POSB payroll account at the Kaki Bukit branch. The feedback from NGOs is that this is a good practice and some have suggested to me that we institutionalise this practice. This will also be of great assistance to insurers who can make more easily their payouts through bank transfers. 

As a matter of standard practice, when commencing a work injury claim, can the Ministry issue such a letter to a migrant worker who does not already have a bank account? 

Next, as insurers will now take over the processing of claims, the task of determining AME now falls to them. I understand that determining the AME can be a contentious issue and there are incidences of erroneous, missing, and forged time cards and salary slips. This is a difficult enough problem for MOM with their statutory powers of investigation. Can the Minister share how the Ministry intends to address the possible difficulties that insurers may face in determining the AME? 

Where a dispute over the AME goes to the Commissioner, the Bill empowers the Commissioner to compute compensation based on a multiple of the employee’s basic monthly salary if there are no other evidence available. Can the Minister share if it will issue guidelines for determining what this multiple should be or if the issue is left entirely up to the discretion of the Commissioner? 

Next, employers are currently required to provide adequate food and acceptable housing for migrant workers during the entire injury compensation process. However, it is not clear what adequate food and acceptable housing means. NGOs have shared with me horror stories where migrant workers are required to travel long distances to their work sites in order to get food when they should be resting, or where they are housed in accommodation with appalling conditions. 

Can MOM look into providing guidelines on what constitutes adequate food and acceptable housing? While this will differ from employer to employer, we are not asking every employer to meet the standards in the same exact way. These guidelines will provide a minimum standard to ensure that employers cannot abuse the ambiguity of adequate food and acceptable housing. 

Next, the Bill also proposes for the compensation to be assessed based on current incapacity (CI) to expedite compensation for the employee. I understand that in practice when the injury is assessed is important because employers consider their responsibilities to be fully discharged upon assessment of incapacity. Can MOM clarify, where the assessment is based on the CI, will the employer be responsible for the medical treatment after the assessment? For instance, is the employer responsible for the cost of a follow-up treatment and for therapy after the assessment?

Can the Minister also clarify whether the Ministry’s intention is for migrant workers to be repatriated after assessment based on CI is done? My concern is that this will have the effect of denying migrant workers continuing care and rehabilitation that may be necessary until their condition fully stabilises.

It also is proposed that employees be allowed to switch assessing doctors to address cases of inadequate care of overly conservative incapacity assessments. The Ministry has stated that the Commissioner may allow employees to switch the assessing doctor in certain cases. Can the Minister clarify under what circumstances the employee will be allowed to switch assessing doctors and whether the employee will be able to determine which doctor to consult? 

Lastly, the First Schedule of the Bill limits the compensation payable by an employer to the cost of medical treatment within one year of the date of the accident. However, it is plausible that bad employers may prevent or obstruct their employees from getting appropriate medical treatment in the first year after the accident. In such cases, can the Ministry clarify whether the employee’s only recourse will be to seek compensation via the common law route? Can the Ministry introduce exceptions to the one-year time bar where the employer has actively sought to prevent the employee from getting medical treatment? 

Sir, I hope the Ministry will provide the clarifications sought and consider my recommendations in subsidiary legislation and implementation of the Bill. I stand in support of what is an overall positive step in strengthening our work injury compensation regime.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Health (a) what are the latest findings in the Ministry’s study on creating guidelines to help doctors determine the disability duration for specific injuries when issuing medical leave and light duties to injured workers; and (b) by what date does the Ministry expect to publish the results of this study.

Dr Amy Khor Lean Suan (for the Minister for Health): The Singapore Medical Council's Ethical Code and Ethical Guidelines (ECEG) requires the doctor to place the patient's welfare above all. Regarding medical leave, the doctor has to ensure that the duration and type of leave granted is based on medical grounds arrived at through proper clinical assessment by doctors. 

The duration of medical leave is determined by a variety of factors including the type and severity of the injury, the period required for the treatment, rehabilitation and recovery, and the specific work requirements and workplace conditions. 

Recent changes in the Work Injury Compensation Act (WICA) to require employers to report any instance of employees on medical leave or light duties due to a work injury, when effected, should reduce the risk of inadequate medical leave.

Therefore, for now, we do not think that guidelines for medical leave on work-related injuries are necessary. My Ministry will continue to monitor the situation.    

Louis: I thank the Senior Minister of State for the reply. I think last year, MOH said that it would consult stakeholders on whether these guidelines were needed. Could I ask Senior Minister of State, which stakeholders were consulted and what their views are?

Second, I think that, while WICA amendments will close some of these loopholes, I think we can further strengthen it. So, I understand that under the MOM Return to Work Coordination Programme, all the public hospitals' Work Rehabilitation Therapists are required to complete and obtain certification before they are qualified to facilitate a worker's return to work. But this is not for the private hospital. So, can I ask whether MOH will work with MOM to ensure that this is made compulsory also for private hospitals' Work Rehabilitation Therapists.

Dr Amy Khor Lean Suan: First, I would like to say that we are as concerned as the Member for the welfare of the workers. Indeed, we have done some preliminary consultations as well as done a survey of the landscape of such issues in various countries, like New Zealand, Australia, UK. As I have noted earlier, I think the general view is that, because the duration and the type of medical leave or even light injury duties that are to be given, really varies widely depending on different persons, the different circumstances, whether it is the type and severity of the injury, the type of treatment required, rehabilitation, even the comorbidity and the fitness of the worker as well as the work requirements and work conditions. All these vary very greatly and it is actually difficult to have a set of prescriptive guidelines for prescribing medical leave and even light duties.

So, that is the reason why the Singapore Medical Council (SMC), in 2017, did issue some general guidelines on what doctors should take into account, as I have enumerated earlier, as well as the fact that they should not take into account extraneous factors like who is going to benefit, who is going to pay, impact on insurance claims and so on, as well as to consult their peers where they may not be sure.

We think that with the new WICA coming into effect from September of this year, where even light duties given – even if it is one day – will have to be reported, that will actually minimise this issue of under prescribing medical leave or light duties. And in fact, one of the benefits of WICA is to enhance protection for the employees. We will continue to consult with various relevant stakeholders as well as to monitor the situation.

With regard to the second question about the therapists, I think this is not quite related to the issue of issuance of medical leave or light duties by the doctors, but nonetheless, we will check and we will work with MOM where if it is needed, to work out the procedures and the process for this.

Source: Hansard (Parliament of Singapore)

As part of his speech in response to Additional Support Measures in Response to COVID-19 Pandemic Ministerial Statement, Louis spoke up for migrant workers as follow.

Louis: My final point is about our migrant friends, workers who have left their homes to come and build and clean ours. News has emerged that two migrant worker dormitories, S11 @ Punggol and Westlite in Toh Guan have been gazetted as isolation areas. Many Singaporeans have contacted me to share their concerns for the safety and well-being of these workers. 

I must first thank Minister Josephine Teo for her comprehensive Facebook post on the measures taken to prevent transmissions and to ensure that the basic needs of migrant workers are met including food, necessities, salary and medical care. Migrant worker dormitories are very densely packed and the workers live in very close proximity. I understand that measures have been taken to implement safe distancing measures and to thin out the dormitories.

However, even with these measures, the risk of transmission is very high. The issue is the conditions the workers live in. 

Last night, I received photos from migrant workers living in one of these dorms and the conditions are still far from optimal. We have to do more, much more to improve the current living conditions. This is vital to stop the outbreak in these dormitories. Beyond the measure we are taking now, I also sincerely hope MOM will do a complete review and ensure that our migrant workers' living conditions are improved significantly. I am glad Minister Josephine agrees with this and has given her word that action will be taken. 

Next, many workers are also afraid that they have been infected with COVID-19. To supplement the measures already taken, can we consider proactively testing the workers in dormitories with infected workers, starting with those who lived in closer proximity to the infected workers? This would assist in definitively identifying those infected and quickly isolating them to prevent a further outbreak. I understand there are limitations for doing this nationwide. Can we do more extensive testing on a limited scale for this high-risk population? This would help to keep Singaporeans safe too and help calm the workers who are extremely worried. 

Lastly, as with Singaporeans, the workers are also worried about their livelihoods. Minister Josephine has said that MOM will work with employers to ensure that quarantined workers continue to be paid and that their period of absence from work is treated as paid hospitalisation leave, as part of the workers' statutory leave eligibility. This has provided a lot of assurance to the workers and they are very thankful. I hope MOM will follow up and ensure that every worker is paid. 

Deputy Prime Minister Heng also announced yesterday that we will waive the monthly Foreign Worker Levy due in April and also provide employers with a Foreign Worker Levy Rebate of $750 for each work permit or S Pass holder. This will help employers pay and take care of the upkeep of their workers, and prepare their workforce to restart when the circuit breaker is lifted. Can I ask whether we will be ensuring that these rebates are passed down to the workers and how will we ensure that the workers are paid their salaries and not put on unpaid leave?

Source: Hansard (Parliament of Singapore)

Louis: I also had a question about the foreign workers living in the dorms. I am just wondering whether we can do the swab test, especially for those who have lived in close proximity to those who were infected. I think many are very worried that they are infected at this point.

Mr Lawrence Wong (The Minister for National Development): So, Mr Louis Ng asked about the management of dorms and whether more can be done to test workers. I would like to clarify and assure everyone that the task force is putting in place a whole series of measures to manage the infection in our foreign worker dorms. That includes taking steps to move out workers in some of these dorms to other areas so that we can better manage them, ensure compliance with all the safe-distancing measures within the dorms. And yes, it also includes stepping up of tests of workers in these dorms. So, to Mr Louis Ng's specific question, we will be doing more to test the workers there as well.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Manpower in each of the past five years (a) how many work permit holders not employed as foreign domestic workers (FDWs) died from injuries or diseases for which the individual was not eligible for compensation under the Work Injury Compensation Act (WICA); (b) how many work permit holders not employed as FDWs suffered permanent disability from injuries or diseases for which the individual was not eligible for compensation under WICA; and (c) whether the Ministry will start collecting this data if it is not already doing so.

Mrs Josephine Teo: Every year, around 0.3% of foreign work pass holders file claims under the Work Injury Compensation Act (WICA). Around 70 claims for fatal injuries and 2800 claims for permanent disability by foreign workers of all pass types are successfully resolved. They constitute the overwhelming majority of claims. Inadmissible claims were mostly because the injuries were attributed to non-work reasons. On average, around 1% of fatal injury claims and 5% of claims for permanent disability were inadmissible.

Regardless of whether the WICA claims were admissible, employers are required to maintain medical insurance for their foreign workers and pay for all medical expenses incurred in Singapore. The Migrant Workers' Centre (MWC) also provides additional emergency assistance to migrant workers who are in need.

Source: Hansard (Parliament of Singapore)

(Supplementary Question) Louis: I thank the Senior Minister of State for the reply. I think the problem really comes in when it is non-emergency cases, where, as the Senior Minister of State had mentioned, they need the LOG. I am just wondering whether MOM would review that requirement as well so that the migrant workers can get access to medical treatment as quickly as possible.

Mr Zaqy Mohamad (for the Minister for Manpower): I thank the Member for his query. In fact, the requests come under the hospitals because they would like to be assured that the employers can pay. In fact, for me personally, I do not think that this is needed. However, the hospitals have a very different view. 

This is something we will continue to work through with the hospitals, to assure them. My sense, as I shared earlier, 95% of cases are covered by both the medical insurance as well as work injury compensation insurance. What the hospitals have committed to is that for serious injury cases, they would take them in, even without the LOGs. For that, there will be no delay in treatment. However, these are things that we have to work through because I know hospitals too are concerned. They have to ascertain first that it is a work injury – that is one part to it. So, whether it is work injury or injury caused by something else. And secondly, the employers should be notified as well when their worker gets injured. Therefore, there is a process in place. But let us work through to see how we can make it more seamless for the workers.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Transport (a) for workers who are transported in lorries, what are the measures recommended by the Ministry that employers can adopt to ensure that workers remain dry if it rains during the journey; and (b) if there are no guidelines, whether the Ministry is considering to implement such guidelines.

Dr Amy Khor Lean Suan (for the Minister for Transport): Since 2011, lorries used to ferry any persons in their rear decks are required to be fitted with canopies. These provide shelter, including against inclement weather. Failure to do so is an offence under the Road Traffic Act. First-time offenders will face a fine of up to $1,000, an imprisonment term of up to three months, or both. These penalties are doubled for repeat offenders.

We take such offences seriously and have been actively enforcing against offenders. For the first half of 2021, we caught 23 offenders with lorries ferrying workers without canopies, or without having a sufficiently large canopy to shelter all workers. We will not hesitate to take stern action against the offenders. Members of the public can call LTA's hotline to report any non-compliance with these regulations.

That said, we strongly encourage all employers to do their part to ensure the welfare of their workers. In the event of severe weather, we recognise that the canopy alone may not confer sufficient protection from the elements. We certainly do encourage employers to take the initiative to install rain covers. These are typically waterproof canvas tarps that are installed on the sides of the rear deck, to complement canopies which serve primarily as a roof shelter. Where possible, employers should also consider putting on hold such trips until the heavy rain has passed.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Transport whether the Ministry will consider requiring lorries that are used to ferry any persons in their rear decks to be fitted with rain covers which are typically waterproof canvas tarps that are installed on the sides of the rear deck.

Mr S Iswaran (MOT): Today, we already require lorries ferrying workers in the rear deck to be fitted with roof shelters or “canopies”. This is a safety requirement, which also provides some shelter for workers in inclement weather. As a further step, many employers have also installed rain covers, which complement the canopies, to better shelter their workers. 

We will work with the relevant agencies to review the Member’s specific suggestion as part of our continuing efforts to safeguard the welfare of workers. We strongly encourage all employers to do their part, including rescheduling trips when there are heavy rains. 

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Transport (a) what percentage of lorries that are used to ferry persons in the rear decks are fitted with rain covers installed on the sides of the rear deck in addition to their roof shelters; and (b) if this information is not currently available, whether the Ministry will start collecting and tracking this information.

Mr S Iswaran (MOT): As shared with the Member in Parliament last month, many employers have installed rain covers, which complement the mandatory canopies, to better shelter their workers from inclement weather.

We do not track the percentage of lorries ferrying workers in the rear decks which use rain covers. Such rain covers are detachable and can be easily installed or uninstalled. Hence, it is not practical or meaningful to collect or track such information.

We will take the Member’s suggestion to require lorries ferrying persons in the rear deck to be fitted with rain covers into consideration, together with other suggestions that have been raised by various stakeholders, as part of our continuing efforts to safeguard the welfare of workers. In the meantime, we strongly encourage all employers to do their part, including rescheduling trips when there are heavy rains.

Source: Hansard (Parliament of Singapore)