Vulnerable Adults Bill

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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