Speech by Dr Amy Khor, Minister of State (Health) at the roll-out of the Singapore Programme for Integrated Care for the Elderly (SPICE) at Tembusu Rehabilitation and Day Care Centre

20 Oct 2011
By Dr Amy Khor
Venue: Tembusu Rehabilitation and Day Care Centre

Introduction

I am happy to be here at the official opening of the Tembusu Rehabilitation and Day Care Centre (Tembusu) and to witness the roll-out of the Singapore Programme for Integrated Care for the Elderly, or SPICE for short, at this Centre.

It is truly a joy for me as Mayor of Southwest CDC to see the revamped Centre after about two months of upgrading works. The Tembusu Management and personnel have certainly stepped up to the challenge of meeting the needs of the elderly in this district.

Impetus for Ageing-in-Place
 
Over the next twenty years, our society will undergo profound change as our population ages. We need to invest adequately in care facilities to respond to the increase in demand. This is part of our ageing-in-place strategy, which includes not only providing for acute hospital capacity, but also long-term institutional and non institutional facilities in the community. This will allow seniors to live meaningfully and productively within their existing homes and communities, drawing upon the network of neighbours, friends and families.

The Government is also committed to ensure that community care services continue to remain affordable for elderly Singaporeans. Subsidies are provided for government-funded Voluntary Welfare Organisations’ (VWOs’) community care services. Last year, we have raised the Medisave daily withdrawal limit for community rehabilitation services to reduce the out of pocket cash payment. With the availability of transport subsidies through the Senior’s Mobility Fund this year, we have further alleviated the financial burden of the needy seniors and their family. Our needy seniors would also be further assisted through Medifund when the scheme is extended to the ILTC non-residential services next year. VWOs may also offer further charity assistance if needed. We will continue to work together with the numerous partners within the community such as VWOs like Tembusu to ensure community care services remain affordable to our seniors.

We will also continue to support service providers in their development and adoption of new and innovative models of care for the elderly in the community. SPICE is one such model. Adapted from the US-based “Programme for All-Inclusive Care of the Elderly”, the Agency for Integrated Care, AIC, has customised it to meet the needs of our elderly Singaporeans. SPICE’s comprehensive service integrates centre and home-based care services, allowing the elderly to be cared for at home amongst friends and family, or in a nursing home setting, if needed. SPICE’s services also give caregivers greater flexibility and respite from caring for the patient.

AIC has been diligently working with VWOs to implement SPICE in Singapore. The programme was first piloted at The Salvation Army’s Bedok Multi-Service Centre last year as Temasek Cares-SPICE (TC-SPICE). One of the many beneficiaries of SPICE was a man in his 90s, named Mr John Forbes. He had major heart surgery early this year. Ordinarily, such a patient may need to see the Specialist Outpatient Clinic (SOC), polyclinic or his General Practitioner (GP) for his medication management, wound dressings, and for the regular monitoring of vital signs. He would also need to go to the Day Rehabilitation Centre (DRC) for rehabilitation services. However, since joining the TC-SPICE programme in March this year, the programme has provided him with the necessary coordinated care at home and in the community. The support given by TC-SPICE has not only enabled Mr Forbes to recover fully, but has also allowed him to regain his ability to continue living on his own. His medical needs are conveniently cared for at home, which saves him visits to the hospital.

Bedok Multi-Service Centre also shared with me an example of a 59 year old lady, Madam Lim Teh Sim, with a nerve problem known as Huntington’s disease. She had difficulty walking, feeding and bathing herself. Instead of admitting her into a nursing home, her family enrolled her into the SPICE programme. Since her enrolment into SPICE last December, Madam Lim has been taken care of by a dedicated team of medical, nursing and allied health professionals, led by a case manager. The team ensures that she has her medication, brings her on hospital visits and makes sure she has her meals and showers daily at the Centre before going home to spend time with her family in the evenings. The programme has not only enabled Madam Lim to remain with her loved ones and in the community but has also reduced the stress of her primary caregivers.

Positive patient outcomes such as that of Mr Forbes and Madam Lim have given us greater impetus to introduce more SPICE centres around Singapore. I am happy to announce that SPICE@Tembusu is the first in the Western region of Singapore, following the success of the pilot.

Importance of Industry Collaborations

Much has been said about the need for patient-centric Regional Health Systems (RHSs) in Singapore. The end-goal is to create an environment where Singaporeans can move seamlessly beyond the hospital across a network of primary care and ILTC providers, without falling through the cracks. This will allow our elderly to receive the care and attention they need, where they need it most, and at a price that they can afford.

I am heartened by the collaborations that have started in this part of Singapore. For the concept to work, close partnerships between the ILTC service providers, restructured hospitals and the primary care practitioners are important. SPICE@Tembusu demonstrates what is possible when all parties work together  We have onboard Sathya Sai Social Service (4S), the parent organisation of Tembusu, the National University Hospital (NUH), Frontier Healthcare and AIC.

Each partner brings with them a wealth of experience and expertise, which is important for this collaboration to succeed. NUH identifies suitable patients for SPICE and conducts geriatric assessments of each patient, to develop a holistic care plan for the individual. VWOs such as Tembusu Rehab and Day Care Centre are key conduits in the delivery of services in the community and provide invaluable care and support to both patients and caregivers. Frontier Healthcare provides the primary care support for patients, should they need it. Together with Tembusu, NUH, Frontier Healthcare and the network of GPs on the ground, this multi-disciplinary team will be able to implement the holistic care for each client effectively. I have no doubt that the various parties will look beyond organisational boundaries, professional cultures and business models to structure care based on what is best for patients and the system.

Closing

As our healthcare providers continue to take steps towards integrating care across different settings, the government will support you in your efforts. With a shared belief in a patient-centric system of care, I believe that AIC will also continue to identify and facilitate even more win-win partnerships between VWOs, hospitals and GPs in rolling out SPICE around the island. Such partnerships are one step towards achieving our vision of an RHS to support our strategies for the ageing population.

On this note, let me once again thank all our partners for your dedication and commitment to facilitating ageing in-place. I commend your efforts to implement new models of care to bring convenience and more importantly enable better care outcomes for our patients. I look forward to more such collaborations. I congratulate Tembusu Rehabilitation and Day Care Centre on its opening and wish the Centre and its implementation of SPICE@Tembusu every success.