COS Speech By Minister Gan On Ministerial Committee On Ageing’s Initiatives

Sir

Introduction

1. Dr Chia Shi-Lu and several MPs asked about the strategies to respond to an ageing population. Let me share the Ministerial Committee on Ageing’s (MCA) strategies and put in context the various new initiatives that have been announced recently.

The Magnitude of Ageing

2. Our population will age rapidly over the next twenty years. By 2030, the population of seniors above 65 years old will nearly triple to reach over 900,000, enough to fill nine Toa Payoh towns today. By then, one in five residents will be over 65 years old, compared to fewer than one in ten today.

3. Fortunately, the majority of our seniors are expected to remain healthy and functional. However, as rapid ageing sets in, the needs of aged care will increase in tandem. By 2030, 117,000 seniors may be semi or non-ambulant, more than double the number we have today.

Ageing-in-Place

4. We must prepare for this rapid ageing well ahead of time. A key focus of the MCA is ageing-in-place. Our survey shows that our seniors prefer to age in place gracefully and with dignity, within a closely knit community.

5. We aim to achieve this in two ways. First, to build an inclusive environment and second, to provide good aged care.

Inclusive Environment

6 .Let me start with Inclusive Environment.

7. We need to make our city “age-friendly” so that our seniors can move around safely and confidently within their homes and also within the community. The Minister for National Development has earlier announced the Enhancement for Active Seniors programme, or EASE in short, to make our HDB flats safer for seniors. In Marine Parade, we are also working with LTA and the town council under the City For All Ages project to improve the environment within the town, so that seniors can move round easily and safely.

8. In tandem, the MCA will continue to promote active ageing so that seniors can keep their minds active and their bodies healthy, and enjoy their golden years to the fullest. We will promote not just health screening but also follow-up post screening, to minimise the risk of downstream health complications for seniors. We will also promote senior volunteerism and lifelong learning.

9. We are already achieving some success. The Wellness Programme, which started four years ago, has spread to 42 constituencies touching some 150,000 residents aged 50 years old and above. Two weekends ago, I attended Hougang Wellness Family Day. The seniors had a great time and so did I. Going forward, we want to implement the Wellness Programme countrywide to all constituencies and eventually reach out to one out of two seniors above 50 years old. SMS Heng Chee How will elaborate on our active ageing initiatives during MCYS’s COS Debate.

10.The MCA will also pay special attention to the group of seniors living alone, which is growing. For these elderly, it is all the more important for them to get involved in community activities, build a close network of friends and neighbours, and avoid the problems of isolation or depression. MCYS has decided to expand Seniors Activity Centres (SACs) to serve seniors beyond those living in rental flats. It will resource the SACs to serve up to 48,000 seniors across different housing types by 2020, a significant increase from the 18,000 seniors served today.

11.We have also sought to integrate elder services with housing developments. Studio apartments, such as the Golden Jasmine in Bishan, come with eldercare centres at the ground floor that provides social and healthcare services to the residents residing within the block and in the vicinity. I also encourage the private developers to build the kind of retirement housing that Dr Chia Shi Lu has mentioned. This is a specific area of silver industry that we should promote and I welcome more ideas from Ms Tin Pei Ling and others on what more we can do.

Good Aged Care

12. Let me now move on to the second area of MCA’s focus, that is, to enhance aged care in terms of better accessibility, affordability and quality.

13. First, we need to ramp up aged care services and facilities significantly to improve access. We have to start now because it takes several years to build the infrastructure and train the manpower.

14. By 2020, we will increase the number of nursing home beds by some 70%, from 9,000 today to 15,600 to meet the needs of severely dependent seniors whose families are unable to care for them at home, as well as those with no family support at all.

15. We will also develop a range of home- and community-based aged care services to support families in caring for their loved ones at home. We will more than double the capacity of home-based healthcare services from 4,000 patients today to up to 10,000 patients, and more than triple the capacity of home-based social care from 2,000 today to up to 7,500. We will triple the number of day social and rehabilitative care places from 2,100 to about 6,200.

16. The $120 grant per month for families to hire a foreign domestic helper will help them to care for elderly family members who are unable to care for themselves. Coupled with the expansion of the various centre-based and home-based services, we hope to keep as many seniors ageing-in-place as possible. We will also step up caregiver training so that they are adequately equiped. Mdm Halimah Yacob will elaborate on home- and community-based care as well as caregiver support during MCYS’s COS Debate.

17. We recognise the constraints of voluntary organisations in keeping up with the pace and scale of this expansion. The government is prepared to take the lead in the hardware development of aged care facilities by bearing the full capital cost of these facilities under a Build-Own-Lease, or BOL, model. This will reduce the financial burden on VWOs who wish to expand their aged care services.

18. In addition to VWOs, we will also be opening up the provision of subsidised nursing home services to private operators, through the use of portable subsidies or inviting the private operators to tender to operate BOL projects. Today, some 700 beds in private nursing homes are occupied by subsidised patients under the portable subsidy scheme.

19. Second, we will make aged care affordable. We have just announced comprehensive enhancements to the subsidy framework for aged care, which will mean a 30% increase of subsidies amounting to some $250M this year. Middle income families will now also benefit from government subsidies for these services, while the lower income will enjoy even higher subsidies. This will ease the financial burden of long-term care for about 30% more patients, or a total of about 40,000 patients.

20. Third, we want to enhance the quality of aged care, which Dr Chia Shi-Lu had asked about. Our seniors today had contributed significantly to Singapore’s progress and we should care for them well when they age and become frail.

21. We will coordinate and integrate services more effectively so that our seniors can be cared for better. For instance, we will build Integrated Day Facilities in the community which would be “one-stop” facilities providing both health and social care for seniors during the day. I would also like to assure Mr Chen Show Mao that the Agency for Integrated Care (AIC), which focuses on healthcare integration and the Centre for Enabled Living (CEL) which focuses on social care, work very closely togetehr to provide client-centric help to seniors and their caregivers. We will continue to evolve the government’s programmes and organization structures to facilitate even better coordination for better care for our seniors.

22. The quality of care in our aged care facilities must also improve. In my visits to various aged care facilities, I was impressed by the dedication and the innovation in this service industry. I have seen how the Wii is used in some day care centres and nursing homes that I have visited, and it has certainly energised and entertained the seniors there! Unfortunately, there are also instances of neglect and abuse at the other end of the spectrum as mentioned by Mr Patrick Tay and Dr Chia. While these are few and far between, when it comes to safe care, we should adopt a zero tolerance policy. One case of abuse is one case too many.

23. The quality of care is a joint responsibility – the government must have a robust regulatory and quality framework in place for aged care, while service providers must constantly improve care delivery and put in place a robust framework within their institution to ensure that care professionals uphold the standard of care required. Seniors and their caregivers can also participate by being discerning in choosing aged care providers and providing timely feedback on services.

24. The MCA intends to work with service providers and the public to enhance care standards in a number of ways.

25. First, reviewing and setting standards. In the MCA’s recent dialogue with stakeholders in the aged care sector, there were suggestions that we should have a clearer definition of what constitutes a good standard of care for the sector. I agree. It is timely to review existing standards and guidelines for aged care services. My Ministry will involve representatives from the public, as well as providers and clinicians, in doing so, so that there is a strong sense of ownership of these standards. We will start with the nursing homes.

26. Second, we want to give seniors and caregivers new avenues to provide feedback on care. MOH will set up a Visitors Programme, where volunteers from across society will be invited to visit nursing homes, chat with patients and give providers suggestions on improvements. This is a voluntary scheme and it is also a useful tool for nursing homes to help identify areas they have done well and areas they can improve upon. To date, 41 nursing homes have signed up for this programme and we have recruited 48 volunteers.

27. Third, resourcing the aged care sector for better care. We have announced significant enhancements to subsidies for the aged care sector. At the same time, the government is prepared to help aged care providers recruit staff, enhance the skills level of their workforce and improve processes, to deliver better care. MOS Amy Khor will elaborate on these manpower initiatives for the intermediate and long term care sector.

Bringing About Change on Ground

28. The next few years will be challenging but exciting. We must gear up as a society, for the pace and magnitude of ageing that will come. Dr Lam Pin Min passionately argued that Singaporeans had to build a common understanding of what was needed to create an inclusive society where our people can age gracefully and with dignity. I agree with him wholeheartedly and also with Mr Hri Kumar Nair that we need a national plan to address the issue of developing facilities for the elderly. As he has elegantly put it and I quote, “The issue is in everybody’s backyard”. Caring well for our seniors is a collective responsibility we all share. Many of the aged care facilities will have to be sited within the community for the convenience of our seniors. On our part, the government will engage Advisors, grassroots leaders and residents on our plans for facility development and to strike a careful balance between addressing the needs of the seniors and the needs of residents in the vicinity. We need the support of grassroots organizations and Singaporeans themselves to make the community inclusive and welcoming for our seniors.

29. I also agree with Mr Laurence Lien that any national effort to address the issue of an ageing population cannot be a government driven one alone. It also has to be community driven. This is indeed what we are doing under the City for All Ages project, where we seek to share the needs of the local community with the local grassroots leaders and non-profit organisations, jointly develop solutions, and empower them to realize their ideas. In Marine Parade, some 70 seniors participated in our town audit by walking around the estate at different times of the day and night, and they surfaced almost 300 suggestions on how the built environment could be improved to help seniors move around more safely and with greater confidence. The Town Council and LTA responded by fixing many of these hardware issues where practical. We also tapped on the many helping hands in Marine Parade. Senior volunteers helped us in conducting functional screening of seniors aged 70 years old and above in Marine Parade. The local Seniors Activity Centre, called “Goodlife”!, responded to the needs of vulnerable seniors by visiting those who said they were living alone, and I know that some of the local RC chairpersons personally keep in touch with the seniors living alone in some of the zones.

30. We intend to foster similar partnerships in Whampoa, Bedok and Taman Jurong. I am also heartened to see many ground-up efforts in other constituencies, such as the MacPherson CARE fund to help needy elderly residents in MacPherson cover medical costs, and the new MediWheels programme in Ang Mo Kio which will make it easier and cheaper for the frail elderly and disabled to move around the neighbourhood. In fact, I just launched the Nurses’ Initiative for Community Engagement, or NICE, in Hougang some two weeks ago, where a group of 100 volunteer nurses commit their own time outside their working hours to visit seniors in the community to conduct health checks and give advice.

31.The momentum is rapidly building up and there is great energy on ground. 所谓 “老吾老,以及人之老”。我们的年长者是对国家有贡献的“宝”。他们是我们家中的宝,社区中的宝,更是国家的宝。我们不但应该尊敬他们,也要珍惜他们,照顾他们,让他们有一个温馨的生活环境,及高素质和负担得起的医药服务。 也让他们能继续过活跃的生活,给他们机会继续贡献家庭社会。

32. So the MCA hopes to continue to work hand in hand with the aged care sector, grassroots organisations, and Singaporeans, to build an inclusive and caring society for our seniors. If we work together with a caring heart, we can turn the challenge of an ageing society into an opportunity to build an outstanding society. Together, we can make this happen. Thank you.

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