At last, somebody within the ruling party has noticed a problem that Transient Workers Count Too have known about for years, and tried to bring to the Manpower ministry’s attention repeatedly: there are plenty of injured workers in Singapore heartlessly abandoned by the system. Indranee Rajah, the People’s Action Party member of parliament for Tanjong Pagar, spoke of how “their employers were not interested in their welfare,” something she learned after speaking to some of them in the area around the Silat Road Sikh Temple. The other root cause, she pointed out, was “the length of time to process the claims” at the Ministry of Manpower. The workers had to depend on charity when the system failed them.

In fact, TWC2’s free meals programme, which aims to help this pool of abandoned workers, is going to mark its fourth anniversary March 15, which only shows how long-standing the problem is. The numbers are also unconscionable.  As can be seen from Cuff Road Project 2011 — Types of cases seen, 1,458 workers registered for free meals last year. Of the injured workers who came to us for food, the median length of stay in our food programme after their accident is about six months. Some of them were still with us 18 months after their injury (see Cuff Road Project 2011 — Injured workers’ length of stay).

Yet, Indranee Rajah’s remarks almost sank without a trace.  The Straits Times did not report them, nor did Today. The New Paper carried the story in its print edition, but for some reason, abridged it so much for its online version that it lost its bite. Fortunately, a well-wisher sent TWC2 an audio recording and transcript of the relevant portion of her parliamentary speech. See Indranee Rajah takes Manpower ministry to task — audio and transcript.

Although Ms Rajah laid the blame on both employers and the Ministry of Manpower (MOM), in TWC2’s view, the solution lies almost entirely with MOM. Employers misbehave either because rules are badly drafted and open to circumvention, or what rules there are are not enforced. In an economic climate that seeks ever-cheaper labour, employers, being rational, can hardly be expected to follow the law, incurring costs, when their competitors flout the law to gain a cost advantage, but are rarely prosecuted by MOM for doing so.

That the problem has the scale and persistence it has is an indictment of MOM.

There are several aspects of the matter, of which three are perhaps the most important. Ms Rajah touched on two — a living allowance for workers and faster processing of claims. The issue of accommodation for injured workers is also crucial and sadly neglected.

However, to understand how these issues are linked, a timeline showing the key events and phases of a typical case may be helpful:

It is important to distinguish between the two phases of a typical case: the first phase — the length of which depends on the severity of the injury — can be called the treatment period, when the chief focus is on medical and surgical intervention, follow-up management and physiotherapy. When not much more can be done, the treatment period ends and a medical assessment is made of any residual permanent disability. This assessment determines the compensation due to the worker under the Workman’s Injury Compensation Act (WICA).

Employers are required to purchase two kinds of insurance: firstly for hospitalisation and medical care, of at least $15,000 a year; secondly for workman’s compensation. It is important not to confuse the two kinds of insurance. It is also important to remember that insurance is only meant to buffer an employer’s  liability. Failure to buy insurance does not release an employer from his liability.

“Fast-track” claims, Indranee Rajah urges MOM

The member of parliament said, “I would, therefore, urge MOM to fast track foreign worker claims, in terms of investigation, evidence-gathering and hearings.” However, the reality presents certain limits to what can be achieved. Wounds take time to heal. The treatment phase as indicated in the timeline above can be impervious to a bureaucrat’s eagerness to close the case, however motivated he may be.

Nevertheless, as many stories on this website attests to, much more can still be done to shorten the treatment phase. Many workers have problems getting treatment in the first phase, so they linger injured but untreated! Another problem is that further diagnostic tests or interventions are delayed (often repeatedly) by employers dragging their feet over a process that the MOM created — a process that is almost the antithesis of efficiency.

That process calls for the employer to sign off a Letter of Guarantee for each and every procedure that a worker needs. Enormous amount of administrative time and effort is expended to obtain such letters. Countless hospital appointments are cancelled (what a waste of precious healthcare resources!) because a Letter of Guarantee has not been provided by the employer. The toll on workers’ emotions, pain and medical complications that result from delay is shocking.

TWC2 has urged the MOM to simplify the system. Since all employers of Work Permit holders are anyway required to take out medical insurance, TWC2 has proposed that MOM issue every Work Permit holder a medical card (sample at right) that entitles him or her to medical treatment at any public polyclinic or hospital. This will allow the worker to seek prompt treatment, and the healthcare institution to provide it without having to go through the rigmarole of getting an assurance that someone would be paying for it.

MOM might be concerned if workers sought treatment frivolously. First of all, how often would this happen? Few workers would want to risk their jobs here, for which they have paid thousands of dollars to secure, by being known as a shirker. Secondly, a doctor can advise the worker that whatever he might be complaining of was not serious if the doctor came to such a conclusion, and caution him or her against abusing the system.

To design a system armoured against abuse that is highly unlikely to happen, but in the process is one that denies or delays treatment to thousands of needy cases is the height of absurdity. Yet, that seems to be what the current system is about.

Food and allowance

The Work Permit Regulations, a by-law of the Employment of Foreign Manpower Act, says: “The employer shall be responsible for and bear the costs of the foreign employee’s upkeep and maintenance in Singapore. This includes the provision of medical treatment . . .”

This is an example of a badly drafted law. Firstly, what is meant by “upkeep and maintenance”? How will the quantum be decided? Secondly, many employers terminate a worker’s job as soon as he is injured. While the law may impose an obligation on employers to pay for medical treatment, and a basic salary while he is on medical leave, or “upkeep and maintenance” as in the cited sentence above, what happens if the employer is no longer an employer?

There should be a third kind of insurance: loss of income while the worker has to remain in Singapore, either for medical treatment or in pursuance of a legitimate claim. This will cover the period that the individual has to stay on to recover from his injury, and for whatever additional period he has to be present on this island to to complete the WICA process. The insurance should also apply when a worker has a legitimate claim against his employer for unpaid or underpaid salaries or other kinds of abuse (e.g. maltreatment). Very often MOM wants the worker to stay for months while the claim is processed, and sometimes months more because the worker may be needed as a prosecution witness.

But MOM has no system in place to ensure that the worker gets a replacement job, or else gets a form of income replacement. This is totally irresponsible.

This third, income-loss, insurance can be pegged to the basic monthly salary as declared in the Work Permit application.

Accommodation for injured workers

The issue of accommodation didn’t seem to have been highlighted by the workers that Ms Rajah met in the Silat area. This led her to say in parliament that “They save on transport by not returning to the dormitories, choosing instead to hang around the precinct next to the temple.”

This is not logical: The workers would anyway have to pay bus fare to get back to their dormitories sooner or later; hanging around the void decks of the housing estate does not make it cheaper.

It is possible that the workers did not give her the full picture, one that TWC2 sees all the time: Injured workers have nowhere to stay. Perhaps the workers in Silat did not want to admit to Ms Rajah that they were homeless and sleeping rough, in fear that she might send the police after them.

There are three reasons why injured workers are typically homeless. Firstly, their bosses would have terminated their employment, after which the bosses would feel no further obligation to provide accommodation. Secondly, sometimes the injury is so bad that the worker just cannot use the accommodation provided. For example, a guy with a broken leg can hardly climb four or five floors to his dormitory room or onto his bed, which could well be the upper bunk of a double-deck bed. And if he can’t put weight on a leg, how is he to use a squat toilet?

But most crucially, too many employers resort to using repatriation agents, whose methods come close to thuggery, to seize workers and bundle them off to the airport. Employers think they will save money on medical care and WICA insurance if they can abort the process by throwing the worker out of the country as soon as possible. Workers fearing such tactics by their bosses will not want to linger in the company dormitory a moment longer.

TWC2 feels that MOM should either operate a dormitory designed for injured workers, or else give non-profit organisations the needed grants to operate one. It will have to be a large dormitory, because at any given moment, there are thousands of such workers.

It is good that a member of parliament has raised the issue of injured workers falling through the cracks in the system. The test, however, is whether MOM is going to do anything about it.  The solutions are not difficult, as one can see from the above; the problem is political will.