Vanaraj Vigneshwaran
By TWC2 volunteer Daniel F, based on an interview in November 2019
Among the many hazards of being a foreign worker in Singapore is the high price to pay for falling ill. Not only are foreigners excluded from healthcare subsidies, many employers also impose penalties on workers for taking a day off sick.
Vanaraj Vigneshwaran, 30, started working for Field Catering and Supplies Pte Ltd in November 2018. The company supplies bottled drinking water to various outlets in Singapore from its warehouse, where Vigneshwaran worked as a forklift operator.
In October 2019, he fell ill, saw a doctor and received a doctor’s certification (“MC”) for 2 days’ rest.
“Boss objected,” he tells me, “and said, ‘If you take MC again, I will send you back’.”
(TWC2 noted that since Vignesh was on an S-Pass, what the boss meant was probably that he might cancel the work pass. S-Pass holders like Vignesh have a right to stay for a month to look for a new job, rather than be summarily sent back.)
In Singapore, employers can terminate a worker’s employment at any time. This power is often used to intimidate foreign employees who would typically have paid thousands of dollars to secure their jobs – jobs that they cannot afford to lose.
Vignesh says his October payslip showed a deduction of $200 reportedly as a sort of fine for taking two days’ MC.
Not only does this seem unjust, it is not even as if Vignesh was so essential to the company’s operations that he couldn’t be spared. The company has “over 50 staff,” he estimates, among which are “three more forklift drivers.” There was enough manpower to cover for him while he was on sick leave.
Feeling aggrieved, Vignesh decided to quit. Another complication arose. He says the company withheld his final salary “because of income tax.” There was something about the employer needing to check with the Internal Revenue Authority of Singapore (IRAS) as to how much tax, if any, was payable.
Thirteen days after quitting, Vignesh went to IRAS to enquire about the outcome of their tax assessment. Other than that he would have to pay about $92, “IRAS told me that my tax [has been] calculated and details sent to the company,” says Vignesh. “Therefore ‘you can go to the company to get your last pay minus the tax,’ they said.”
“So I tried to call the company, but they blocked my phone number.”
Vignesh then went to the Ministry of Manpower to lodge a salary complaint. He has been given appointments there to meet with officers to progress the case and I wish him all the best.
Five minutes later, another worker with similar problem
Sivaga [not his real name] comes by TWC2’s meal station just minutes after Vignesh leaves. He has not yet lodged a case and is still in work. However, he needs advice about what he can do regarding a medical problem he is facing.
After finding some blood from his anus, he went to see a doctor at a clinic in Jurong (Pioneer area). The doctor gave him some pills and told him that if it didn’t improve, he may need to be seen by a hospital. That first consultation cost $30, and “company then cut $30 from my salary,” Sivaga tells me.
Apparently, the condition has not improved and there’s still blood. So, as advised by the doctor, he feels he needs to go to a hospital. His concern now is how much that will cost and whether the company will pay.
Sivaga has a sense – rightly – that going to a hospital, even for tests, will be very expensive relative to a migrant worker’s salary. Indeed, a typical public hospital will charge foreign workers something like $120 for a visit to the Emergency Centre.
I check with a senior volunteer and he speaks directly to Sivaga.
He tells Sivaga that under the law, the employer should cover the cost of medical treatment when treatment is deemed necessary. Employers are required to purchase medical insurance and so the amount should be claimable from the insurance company. Generally speaking, employers should not be deducting it from workers.
In Sivaga’s case, the senior volunteer advises that he first go back to the GP clinic for a follow-up review and if the doctor there still thinks he should go to a hospital, then Sivaga should ask for a formal referral letter. That way, it will be clear that going to the hospital is medically necessary.
The gloom on Sivaga’s face lifts. He’s glad he came by to ask. Except that…
“Company say if I go hospital then they will cut my permit.”
“Yes, that is a real problem,” the senior volunteer responds. Once again, it is the freedom employers have to terminate employment at will that enables them to intimidate workers from seeking medical treatment. Explaining that conundrum to Sivaga, our senior volunteer sums up: “You can get medical treatment, but we cannot guarantee that you will be able to keep your job.”
It is quite immoral that workers are presented with an either-or choice between medical care – which the law says they are entitled to – and the job. The “right” to healthcare is thus a bit of a joke, and this cannot be anything but a stain on Singapore.
What does the law say?
In the Fourth Schedule of the Employment of Foreign Manpower (Work Passes) Regulations 2012, which pertains to Work Permit holders such as Sivaga, it says:
Except as the Controller specifies otherwise in writing, the employer is responsible for and must bear the costs of the foreign employee’s upkeep (excluding the provision of food) and maintenance in Singapore. This includes the provision of medical treatment, except that and subject to paragraphs 1A and 1B, the foreign employee may be made to bear part of any medical costs in excess of the minimum mandatory coverage if —
(a) the part of the medical costs to be paid by the foreign employee forms not more than 10% of the employee’s fixed monthly salary per month;
(b) the period for which the foreign employee has to pay part of any medical costs must not exceed an aggregate of 6 months of his period of employment with the same employer; and
(c) the foreign employee’s agreement to pay part of any medical costs is stated explicitly in the foreign employee’s employment contract or collective agreement.(bold text highlighted by TWC2)
In the Fifth Schedule of the Employment of Foreign Manpower (Work Passes) Regulations 2012, which pertains to S-Pass holders such as Vignesh, it says:
Except as the Controller specifies otherwise in writing, the employer is responsible for and must bear the costs of the foreign employee’s medical treatment in Singapore, except that and subject to paragraphs 2A and 2B, the foreign employee may be made to bear part of any medical costs in excess of the minimum mandatory coverage if —
(a) the part of the medical costs to be paid by the foreign employee forms not more than 10% of the employee’s fixed monthly salary per month;
(b) the period for which the foreign employee has to pay part of any medical costs must not exceed an aggregate of 6 months of his period of employment with the same employer; and
(c) the foreign employee’s agreement to pay part of any medical costs is stated explicitly in the foreign employee’s employment contract or collective agreement.(bold text highlighted by TWC2)
Clearly, threats of serious repercussions including termination of employment violate the intent of the law.
Before going further into this discussion, it should be borne in mind that denial of medical treatment is not an across-the-board phenomenon. We have seen good employers too. Employer attitudes to migrant workers falling sick vary across the spectrum from being truly understanding to punitive. The cases that come to TWC2 may be skewed to the latter end of the spectrum.
Nonetheless, cases like those reported above aren’t rare. Vignesh and Sivaga would be far from the first ones to report threats of dismissal should they seek medical treatment.
How to deal with this issue?
One way would be to try to enforce the law about their right to medical treatment by going to the authorities. Should they be dismissed, a case of unfair dismissal can be brought. But the cost and duration of the whole exercise might prove disproportionate to the medical bill. Would a worker want to wait possibly months for the case to be resolved? Would he really want to be reinstated to work for the same boss? Would he get employer-paid medical treatment while the case is sorted out and can his health condition wait so long?
If enforcement is not a practical solution, what is?
At the root, the issue is that of power imbalance between employers and migrant workers. There is enormous supply of willing migrant workers from source countries and employers are able to find replacements easily. The highly skewed supply-demand equation means greatly reduced bargaining power for workers, leaving them vulnerable to unreasonable bosses and threats of termination.
Moreover, some of the more unscrupulous employers benefit financially from churning their workforce. Each time they recruit a new worker, some part of the recruitment fee may go to the employer. If an employer has a habit of taking a cut of the fee, it becomes financially more profitable to sack a worker and replace him with a new one than to keep an existing worker and pay his medical costs.
Having laws on the books about workers’ right to healthcare is quite useless under such macro conditions.
TWC2 has long urged a different approach. We say that the supply-demand imbalance must be rectified to correct this distortion of bargaining power. It should be made much harder to hire fresh workers from abroad. Unless the total manpower demand for any industry sector is growing fast, employers should be mostly restricted to hiring from the available pool of migrant workers already in Singapore who are looking to move on in their careers. Doubtless, this will be a more limited pool. But it is precisely when employers cannot tap an abundance of new workers from abroad to replace those they are quick to sack, that they will treat their existing workers better.
Furthermore, a benefit of any policy that makes employers hire mainly from the already-here pool is the retention of skills (including socialization and adaptation to Singapore language and culture) and improved productivity that comes with it.
Getting macro conditions right is surely more efficient and effective that having case after case show up at the Ministry of Manpower complaining of denial of medical care or unfair dismissal, generating more work for the ministry’s officers.