Monday 10 March 2014

Help for the disabled: Budget 2014

Breaking down the barriers
The Budget gives people with disabilities a $30 million helping hand, and follows several other big-ticket measures for them, amid a shift to a more inclusive society. Insight looks at the winding journey to reach this stage, and where to next.
By Charissa Yong, The Straits Times, 8 Mar 2014

AS A child, Mr Edmund Wan dreaded taking public buses to school so much that he would walk half an hour in the heat instead.

Back then, bus drivers waited for no man - an ordeal for Mr Wan, who walks with a limp as his left leg is affected by polio.

"Today's buses stop, open the door and let you on. The buses I travelled on then, expected you to run after them and jump up.

"You had to gather momentum, otherwise you'd fall. I fell down so many times, with my school bag and everything. Worse still, the bus driver didn't stop. Those were the days," recalls Mr Wan, now 70 and president of the Handicaps Welfare Association.

But these days, things are different - at least when it comes to helping the physically and mentally disabled get around, enabling them to participate more in society and also helping them to obtain medical treatment they may require.


It is one of several multi-million-dollar measures over the past few years that herald Singapore's shift to being a more inclusive society.

Most prominently, public transport fare concessions and subsidies, long on the wish list of the disabled community, of up to $50 million were announced last November.

These deliver on political signals over the past decade that the disabled are no longer to be left out, including the two Enabling Masterplans in 2007 and 2012.

Insight looks at the winding journey the disabled community took to reach this stage, and where it will go from here.

The arduous journey

THE Government only began moving decisively on disabled-friendly public transport and infrastructure in the last 20 years.

Before that, many with disabilities had difficulty getting from place to place, let alone at an affordable rate. This hindered them from integrating into mainstream society, argued advocates.

People with disabilities had to pay full fares to use public transport, which did not have disabled-friendly facilities such as lifts and ramps. Nor did the Land Transport Authority (LTA) show signs of relenting.

In a 1992 letter replying to blind activist and founder of the Disabled People's Association (DPA) Ron Chandran-Dudley, SMRT had said wheelchair users would "most certainly hamper rapid evacuation" in an emergency.

"The transport needs of the wheelchair-bound certainly deserve attention but the MRT is not the solution," it said then.

Cost was the other, larger consideration. The authorities wanted to find an economical approach to transporting large numbers of people efficiently. This trumped making public transport fully accessible to every single person.

LTA's chief executive back then pointed out that adding and maintaining equipment such as hydraulics for wheelchair-users to all 3,800 buses in its fleet would cost $47 million.

The battle between the two opposing viewpoints, with transport as a touchpoint, was fought in forum letters over the 1990s.

Mr Wan, who by then had become an advocate, describes it as "a hard approach of persuading and being slammed down".

"You have to accept whatever the answer is, it may not be their priority, they may not have the resources, you just accept it. Sometimes you need to catch a break," he says.

That break came in 2001 - the Government reversed its earlier stance and announced that it would spend $81.5 million to retrofit all existing MRT stations with ramps, lifts and toilets for the disabled by 2004.

Stations along the North-east Line were already being built with such barrier-free facilities.

In 2008, the Government vowed all public buses would be wheelchair-accessible by 2020.

In February this year, the LTA finally announced that disabled adults would get public transport fare concessions of 25 per cent.

The ageing population was inadvertently the disabled community's biggest ally in precipitating these changes.

The needs of the elderly, which dovetailed with the needs of the disabled, "opened up that little window where (such infrastructure) was seen as a priority", says Mr Wan.

Although lifts in MRT stations would not have made economic sense for just the 5,300 registered wheelchair-users in 1998, it does when the growing number of seniors needing these facilities were taken into account.

Today, there are about 450,000 people aged 65 and over.

State and societal attitudes towards people with disabilities were also changing as the country developed economically.

"Singapore is a very pragmatic society, and I don't fault that. We began with nothing and survival was instinctive. Naturally, we looked at what can add to our gross domestic product, and if it didn't, we'd put it aside," says Christian Outreach to the Handicapped (COH) executive director Samuel Koh, 57.

"But now, we're in a better position to help those we've neglected."

The disabled community's consistent lobbying, and compassionate political leaders, were contributing factors, they say.

Mr Wan, who believes that advocacy should be "evolutionary rather than revolutionary", says: "We didn't bang tables. But we persevered, and we won."

Advocates worked hard at raising public awareness of disabledissues through fund-raising, as well as writing and publishing articles.

"We believe we first need the support and understanding of the public because they form the larger segment of Singapore," says Mr Wan.

It was also very important to have a listening ear and compassionate people in high places, says Mr Chandran-Dudley, now 79.

The stalwart advocate, who has been blind since 17, began his advocacy in the late 1950s, visiting kampungs to persuade families to send their children to the first school for the blind in Singapore.

"That was one aspect of trying to equalise opportunities for blind children, by giving them education, although at kindergarten and primary school level," he recalls.

There was also usually some behind-the-scenes discussion and give-and-take before breakthroughs happened.

"We were facing blockages...but if you had the right key, the locks would open," Mr Chandran-Dudley says.

For example, he had faced some difficulty in registering the DPA in the 1980s until he and several others were invited for a meeting with former prime minister Goh Chok Tong, who helped the advocacy group to get registered.

Moulmein-Kallang GRC MP Denise Phua, who has a son with autism, has also been a tireless advocate in Parliament for the disabled cause.

"If the state can take over, the message will better succeed," says Mr Wan.

And the state did take over. For example, the Building and Construction Authority made it mandatory in 2002 that all new buildings must include more disabled-friendly facilities and be universally accessible.

Stage 2: Expansion

POLITICAL milestones and policy changes came more frequently.

Prime Minister Lee Hsien Loong envisioned Singapore as an inclusive society in his maiden National Day Rally speech in 2004. He pledged to pay attention to several marginalised groups including the disabled, whom he described as "our brothers and sisters too".

In 2007, the first five-year Enabling Masterplan was announced. The wide-ranging blueprint listed key recommendations to improve programmes for the disabled.

These spanned the areas of early intervention, employment, caregiver support, community and residential care, public education and manpower training.

It recommended that early intervention programmes be funded through a combination of fixed and means-tested subsidies - for example, laying the groundwork for the more extensive programme subsidies announced in this year's Budget.

The Masterplan continues today, with its second edition released in 2012.

COH's Mr Koh believes the national blueprint for the disabled community "speaks volumes".

"We've never had anything like it. The mindset is different. It's not just charity money... the money spent is supposed to enable them. It augurs well," he says.

The daycare he runs for about 100 people with intellectual disabilities has been receiving more government grants, in addition to its public donations.

This has helped them employ more staff and become a more professional outfit, says Mr Koh.

Singapore also last year ratified the United Nations Convention on the Rights of Persons with Disabilities, a formal move which signals that the Government recognises the needs of those with disabilities, say advocates.


The state has also strengthened the safety net for the more vulnerable groups, such as helping to ensure mentally disabled children remain cared for all their lives.

The Mental Capacity Act was enacted in 2010 so parents can request the Courts to appoint individuals to care for their mentally disabled children after they die.

These children can also receive monthly payouts from the Central Provident Fund accounts of their parents on their death, under 2011's special needs saving scheme.

The Government also continues to pour more resources into programme and equipment subsidies for the lower- to middle-income groups, a trend that continues in this year's Budget.

This year, all Singaporean children enrolled in early therapy and educational support programmes will be subsidised by at least $500 a month, up from $300 now.

Additional subsidies were extended to cover four in five households, compared to one in two now.

The Budget also gives subsidies of up to 80 per cent for dedicated transport or 50 per cent for taxi travel. These address the needs of those with more severe physical disabilities who cannot use public transport. They would not have been part of the 50,000 with disabilities who benefit from last November's public transport fare concessions. However, only the lower two-thirds and half of households respectively qualify for the dedicated transport and taxi subsidies.

Mr Alvin Lim, chief executive of Bizlink, a non-profit organisation that provides employment services and job assessments for the disabled, says that these transport subsidies and concessions "will bring more and more people out into our mainstream society".

By lessening the burden of transport costs, this will enable them to step into the community and even work, he adds.

The moves cap the removal of the "first barrier" to integrating disabled people into society, Society for the Physically Disabled (SPD) executive director Abhimanyau Pal, 48, says.

"We used to go for very hard issues like the MRT, roads, schools to be accessible, very basic physical rights that a human being should be participating in the community.

"Almost every day in the 1980s we used to hantam (Malay for "hit") the authorities for it," he says.

"But now, as a whole society we are getting more mature. Physical barriers are the easiest to tackle, as long as we have national resources, our GDP is growing quite well, we can settle it."

No rest for the advocate

ALTHOUGH the No.1 item on the disabled community's wish list - transport subsidies and better mobility - has been addressed, they are adamant that Singapore cannot rest on its laurels.

These days, they attend focus group discussions and give feedback about where policies can be improved.

Fine-tuning and plugging the gaps in existing policies still need to be done. The Government could also go further and move faster, they say.

The deadline that all buses must be accessible to wheelchair users by 2020 may be too slow, says Mr Wan, though he quickly adds: "But do I have a choice?"

Slow implementation of policies may also be a problem for the lower-income disabled, who grapple with daily inconveniences as they wait for their subsidy applications to be approved.

It took Madam Madiah Atan, 59, several months before taxi subsidies for her wheelchair-using son were approved. In the interim, he had to wake at 5.30am daily to get to school on time via public buses, which were often too full to fit him.

Advocates say gaps like these show that resources alone are not enough, though they are a good start. Smooth implementation is also needed.

A perennial woe for people with physical disabilities is when facilities meant for them, like parking lots for the handicapped, are misused by others. This can be resolved by better enforcement or stiffer fines, urges Mr Wan.

It is not enough to simply give money to help the disabled buy equipment to help them with their daily lives, such as wheelchairs, says SPD's Mr Pal, who wants more professional centres to be set up so the disabled can get recommendations on what they need.

But just as importantly, besides giving the disabled the means to step into society, society also needs to fully accept them.

This is what Mr Pal calls the "psychosocial barrier" - society still does not perceive the disabled as equal.

"There's improvement in integration, but not by leaps and bounds. A lot of people with disabilities in poorer families, their parents hardly bring them out... some may still find them shameful and embarrassing," says COH's Mr Koh.

Advocates agree that more public education is needed.

Mr Pal argues that not just the Government should do more, but also the private sector and society at large.

"If you're totally relying on government grants, you're standing on one crutch. If one economic crisis comes, that crutch is taken away, you collapse. It's slow because three hands have to come together, but more sustainable," he says.

Mr Chandran-Dudley says: "This is where civic education comes in. It's important to educate people in schools."

This can curb the problem of the public abusing facilities and services meant for the disabled, he adds.

The DPA recently proposed a civic education module to raise awareness of disability issues among students. It has been in talks with the Education Ministry.

There are already positive signs. Last year's disability awareness event, the Purple Parade, shows the public supports government efforts in creating an inclusive society, believes Singapore Association for the Deaf president Christopher Low.

In announcing help for the disabled in his Budget speech, Deputy Prime Minister Tharman Shanmugaratnam voiced the view that they deserved more help: "Their difficulties are the greatest, and often their courage, too. They deserve greater support."

This is a far cry from the reservations expressed by one political officeholder at a youth forum in 2008 that more aid for the disabled might encourage more people to claim they were disabled to get those benefits.

Says Mr Wan: "We've come a long way. Today is better, but tomorrow we can be even better still."





No clear data on disability situation in Singapore
By Charissa Yong, The Straits Times, 8 Mar 2014

JUST how many Singaporeans are disabled is unclear, which has prompted calls for better data.

Singapore has about 97,200 people with disabilities, with the vast majority - 77,200 - above 18 years old, according to 2010 data from the Health and Education ministries.

However, no one knows the exact number for sure.

This is because there is no official central registry of the disabled here or comprehensive disability study done. Current figures also do not accurately capture the full population of people with disabilities.

This problem of not having specific data had been flagged in the Enabling Masterplan 2007 and 2012. Both editions of the national blueprint for improving disability programmes called for a study to determine the prevalence rate of disabilities in Singapore.

Disability advocates agree that some form of study should be done to help the authorities better meet the needs of the community.

"Statistics are important. When you know the numbers, then you know how to plan," says Mr Ron Chandran-Dudley, 79, who founded the Disabled People's Association.

"But if you don't know the numbers, people can sit back and say (services and programmes are) too expensive. We are a very pragmatic nation, so let's look at the numbers. How many of our people are deprived? We won't know otherwise."

Handicaps Welfare Association president Edmund Wan agrees it will be beneficial to know such figures. "Then we can target help. Is it a growing problem in this sector? We really don't know," he says.

The current figures are based on two aspects: First, the number of people who use disability services provided by government agencies. But this does not capture people who do not use such services.

It was for this reason that the Central Registry of Disabled Persons closed in 1987.

Disabled people who did not access government services had no incentive to register. Keeping the register current had also been a problem, says the Enabling Masterplan report.

Second, current figures are also extrapolated from the proportion of children below the age of seven who are diagnosed every year with patterns of developmental problems - about 1,400, or 3.2 per cent of the cohort.

But this may be inaccurate as some children may not be diagnosed. Furthermore, it may not be representative of older segments of the population, says the report.

According to 2010 data from the Health and Education ministries, about 7,000 pre-school-aged children are disabled. Another 13,000 young people between seven and 18 years old have disabilities. Of these, about 7,600 go to mainstream schools and 5,400 to special education ones.

Furthermore, because definitions of disabilities vary between countries, Singapore cannot rely on the number of disabled people in other countries as a "reliable benchmark", cautions the report.

Asked if a national study to address these issues is being carried out, a spokesman for the Ministry of Social and Family Development replied that it "continues to engage and work closely with the relevant stakeholders in developing a continuum of options, in early intervention, work or care, to meet the diverse needs of persons with disabilities".





Transport help for the disabled and lower-income
By Charissa Yong, The Straits Times, 8 Mar 2014

GETTING to school on time used to be a challenge for Mohamed Shukur, 15, who is permanently in a wheelchair.

The Secondary 3 student, who has had a blood clot in his spine from a young age, found that buses were so crowded he could not get on. There was no space for him, his wheelchair and mother.

"When the bus comes, there are so many people that we can't take it and must wait for the next one," says his mother, Madam Madiah Atan, 59.

Despite waking up at 5.30am, Shukur was constantly late for school. Fed up, Madam Madiah applied for, and obtained, the Land Transport Authority's (LTA) taxi subsidies so they could take a London cab - the only taxi large enough to fit in Shukur and his wheelchair.

These cost a flat fee of $40 a ride, so without a subsidy Shukur and his mother could not have afforded such rides.

Says Madam Madiah: "I'm not working and I have no income. Without government help, how to afford this?"

Taxi subsidies will soon be extended to help more people with disabilities.

Currently, the LTA scheme is for disabled people from families with an income per head of under $1,500 per month.

The new taxi subsidies announced in the Budget will subsidise up to half the cost of taxi travel for the lower half of households. Singapore's median monthly household income was $7,870 last year, and the subsidies will now capture those earning above $1,500 but still in that lower half.

More details will be released next week.

Other new subsidies will cover up to 80 per cent of the cost of dedicated transport to school and care services for the lower two-thirds of households.

These new transport subsidies announced in the Budget last month most benefit disabled persons from the lower- and middle-income brackets.

Shukur lives in a one-room rental flat in Bendemeer with Madam Madiah and his older sister. His two other older siblings are married and live elsewhere.

The family gets about $370 a month from the Islamic Religious Council and the Central Singapore Community Development Council (CDC).

They pay utility bills of about $140 monthly, as the CDC helps them with the rest. Their electricity bill comes up to about $200 monthly because Shukur's motorised wheelchair needs to be charged for eight hours daily.

Madam Madiah is thankful the Government doubled subsidies for wheelchairs and such equipment to $20,000 a person in 2012.

Shukur's old wheelchair broke down last year, and he recently applied for a new one which costs $10,000. Meanwhile, he uses a wheelchair on loan from a voluntary welfare organisation.

Says Madam Madiah: "We can't use his old (manual) one. When I push him, I get very tired, so I have to sit down a lot."

Social workers have told her it can take about six months for the application to be processed.

"It can be faster," she says.

Her son, who attends MacPherson Secondary School, is also glad about the public transport concessions, which he says will benefit him later in life. Adults with disabilities get a 25 per cent discount on fares.

"Sometimes when I want to enjoy fresh air, I take the MRT to Bugis or Orchard with my mother or cousins," he says. "I still want to go out too."


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