By Cheong Kwok Wy
Enshrined in the constitution of the World Health Organisation, the notion of basic healthcare is widely regarded as a fundamental right for every human being. By and large, Singapore does provide that right to every transient worker that comes here, such as through mandatory health insurance. Our Work Injury Compensation Act and Employment of Foreign Manpower Act requires employers of work permit holders to take out work injury insurance and medical insurance for every employee. However, some workers do slip through the cracks – necessitating TWC2’s Road to Recovery (R2R) programme.
The mission of R2R is to provide direct assistance to transient workers needing medical treatment, when access to such treatment is obstructed or complicated in some way. Volunteers from TWC2 accompany the injured worker to hospital, helping him communicate with medical staff, and making sure he understands the prescription and treatment programme that lies ahead.
Most of the workers in the programme have work-related injuries, requiring a report to the Ministry of Manpower and the acquisition of a “Special Pass” which enables them to legally stay in Singapore until their work-related injury claim is concluded. Unfortunately, a condition of the Special Pass is that they may not seek employment elsewhere. In any case, some of them are not fit to return to work.
According to the law, wages are to be paid for the period of medical leave. Even if the Special Pass worker is post-medical leave, the employer is supposed to provide “maintenance and upkeep” until his work injury compensation case is over. “Maintenance and upkeep” is understood to mean meals, housing and essential medical care, but with no cash component — which absurdly means that the worker does not have bus fare to go to for treatment or physiotherapy.
However, things don’t always work according to law. Employers have been known to unreasonably withhold any of the above provisions. Hospitals have been known to cancel treatment appointments when employers fail to pay for previous sessions.
More particularly, should the employer dispute the details of the workplace injury (e.g. deny that the accident was work-related), the worker is left in an unenviable position. His right to medical care becomes mired in dispute and uncertainty.
If the worker was conscientious about keeping all his documents and paperwork, he could build a case for employer neglect and head to the Ministry of Manpower to lodge a complaint. However, given the time needed for officers at the Ministry of Manpower to verify the facts, this can lead the worker to be stuck in a kind of limbo for a significant period.
In the meantime, unless he has the resources to pay for medical treatment himself, he may find his hospital visits suspended. Full recovery may be jeopardised. This is when the R2R volunteers of TWC2 step in. We try to put his treatment back on track.
The biggest tragedy is that the R2R programme is entirely avoidable. Procedures for workers to easily and legitimately seek medical treatment are already in place. Going through the legitimate channels, the workplace injury compensation process is supposed to be painless. Medical insurance coverage is required for all Work Permit holders, which would cover most conceivable costs of medical treatment. Yet, errant employers persist in denying their workers their fundamental rights, leading to a long, expensive, and drawn-out fight between the stakeholders involved.
Yes, MOM does investigate violations of these procedures. It is however undeniable and unavoidable that these investigations will take time. In my experience as a R2R volunteer, most injured workers just want to conclude their case, recover from their injuries or illnesses, and return home. The last thing they want is to have their case drag on, in a country that was only meant to be a temporary workplace.
Still, many of the workers we accompany in R2R are grateful for our presence at the hospital. Some of them find the atmosphere there intimidating, due to their limited English and the often-confusing medical terms used by the hospital staff. Our presence helps reassure the worker that their medical needs are being met equitably and, in the event of language difficulty, we can relay the information to the worker in a slower and more easily understood fashion.
Although volunteering with R2R offers only a limited experience of the issues some transient workers in Singapore face, I believe that our assistance does tangibly benefit the workers in the programme. Hopefully, as workers’ rights in Singapore continue to improve, fewer and fewer workers will require our assistance.
Tertiary student Kwok Wy has been volunteering for quite a while with TWC2’s R2R and other projects.