Speech by Mr Gan Kim Yong, Minister for Health, at official opening of Society for the Aged Sick's Tower Block, 31 July 2014

Introduction

1.           A very good morning to all. It gives me great pleasure to join you here today at the official opening ceremony of Society for the Aged Sick (SAS)’s Tower Block. I was here three years ago to witness the ground-breaking ceremony. The new tower block is indeed a significant milestone in SAS’s development.

Building Capacity in Aged Care Services

2.           SAS's expansion mirrors the rapid growth of the nursing home sector in Singapore. In anticipation of the increase in demand for nursing home services that will come from a fast ageing population, MOH has put in place plans to expand the capacity, enhance the affordability, and improve quality of nursing home care services, to bring more, better, and affordable care to our seniors.

3.            Some two years ago, we announced our plans to develop ten new nursing homes by 2016, adding some 3,000 beds, to make nursing home care more accessible for our seniors. Most of these are developed for subsidized patients through a Build-Own-Lease (BOL) approach. Under this model, MOH builds and owns the homes, and selects an operator who can provide affordable and quality care through an open and competitive Request for Proposal (RFP) process. The aim of this approach is to reduce the capital commitment needed and lower the barriers to entry for nursing home operators.

4.           Since 2012, MOH has launched four such Requests for Proposal and these RFPs have thus far attracted good interest from various providers. The bidders comprise a mix of existing nursing home providers as well as new entrants. We welcome the increasing interest in this sector, which will make for a more diverse and robust sector going forward.

5.           With more rapid population ageing in the next couple of decades, we need even more nursing home capacity to meet the anticipated increase in demand for nursing care.  Even as we push on with the development of these 10 new nursing homes, the Ministry of Health has plans to build another nine more BOL nursing homes between 2017 and 2020, which will add a further 2,000 nursing home beds to our capacity.

6.           Beyond building nursing homes, we should also look to provide  seniors and their families with more options to look after their needs near or within their own homes.  Whether it is care within a nursing home or at home, we hope to equip our health and aged care staff with the necessary training and development to make them more effective.  The development of a strong core of local staff must complement our efforts to add capacity.

Developing the Nursing Home Sector

7.           MOH intends to adopt a three-pronged approach to expand, develop and offer more options in the eldercare sector

8.           First, we will need to nurture the growth of larger players who have economies of scale and are able to provide a comprehensive range of services to meet the needs of our seniors. They will also stage home care services from their nursing homes, so that seniors can be supported seamlessly back home after receiving nursing care in the nursing home. Moreover, these operators will also have to recruit and train care workers as part of their workforce. We will be calling some Requests for Proposal that will involve more than one nursing home in one exercise to cater to these larger operators. These nursing homes will be largely within the same geographical region, so that operators can manage resources synergistically across the homes. Potential operators who want to participate in these larger exercises will have to be prepared to provide more holistic care for our seniors. The first of these larger Requests For Proposals will be launched next month. These exercises will be open to both existing and new players, and from both the VWO and private sectors, to allow larger operators to emerge via a competitive process.

9.           Second, beyond the BOL model, we will release suitable land sites and state properties for the private sector to develop into nursing home facilities. These sites will be tendered out to private operators who may like to own and operate their own nursing home facilities to cater to their own market segments with their own models of care.  This adds to the variety of options available to families. 

10.       Third, in order to catalyse the development of innovations in eldercare services, MOH will also consider directly operating a few nursing homes for subsidised patients primarily.   Our intention is to operate a small number of eldercare facilities where innovations can be incubated and new care models evolved and tested. The innovations, if successful, will be shared with the rest of the eldercare sector, so as to spread good practices and allow more of our seniors to benefit. It will also allow us to better understand the operational issues on the ground and develop deeper knowledge about the sector. Our intention is not to become a major player in the market. Hence, we only intend to directly operate about 1,000 beds by 2020, or about 6% of total capacity then.  This capacity will be in addition to, and not in place of, the planned capacity of 15,600 beds by 2020 announced earlier.  There will be enough new capacity planned to support the growth of new and existing providers.

11.       Taken together, this means that we will have a total of some 17,000 nursing home beds by 2020, slightly higher than the 15,600 announced earlier. We are ramping up faster to create room for more players to accelerate the pace of innovation.

12.         We will continue to help nursing homes, especially smaller ones, improve care standards. MOH has introduced a set of enhanced nursing home standards, so that over time, the overall quality of care in the sector can improve, and every nursing home will provide good quality care that our seniors deserve. The Agency for Integrated Care (AIC) has launched a guide to the standards in April this year to help nursing homes work towards achieving the new standards. The guide provides examples of activities, processes, good practices and sample tools for nursing homes to work towards the new standards. AIC is also in the midst of conducting voluntary baseline assessments for nursing homes to identify areas which they need to improve on. To date, about 85% of nursing homes have signed up for these assessments. Based on the findings from these assessments, AIC will put in place training programmes to support our nursing homes in raising their standards.

SAS Expansion

13.        I am heartened that SAS, with its 46 years of tradition, is taking the lead to scale up its capacity, and is a firm believer in providing quality care. SAS’s strong focus on quality care can be seen in the design of this new tower block. The open concept, greenery and landscaping at the ward levels provide a pleasant environment for the residents. I understand that the expansion has added a doctor consultation room, a dental room, an occupational therapy room and a physiotherapy centre, all of which will allow SAS to provide more holistic care for its residents. With the expansion, SAS now has the space and facilities to organise more activities to engage its residents.

14.       Since 2009, SAS has also been actively collaborating with Tan Tock Seng Hospital (TTSH) to develop care plans that address the clinical and psycho-social care needs of each resident in SAS. Through this collaboration, the Home has seen a decline in hospital readmissions for its residents. In the last 15 years, SAS has worked with the Aljunied Community Centre Women’s Executive Committee and Paya Lebar Zone 7 Residents’ Committee to organize monthly birthday celebrations for its residents.  Such whole-of-community efforts enable our seniors to age in place gracefully and to feel welcomed.

15.       Quality care cannot be delivered without quality staff. SAS has been an accredited training centre of ITE for the Industrial Skills Certificate in Health Care (Home Care) since 2004. The course helps the Home’s support care staff to upgrade their skills in patient care, and serves as an avenue for staff advancement. I understand that some of the nursing aides who graduated from the course have become Enrolled Nurses and some have even progressed to become Registered Nurses. With its new tower block equipped with a training laboratory and classroom for staff training, SAS will be better able to expand its manpower development efforts.

Nurses’ Day Celebration

16.       Before I end, I would like to take this opportunity to acknowledge the hard work of our nurses, especially those in the Intermediate Long-Term Care (ITLC) sector such as those in SAS, as they play a crucial role in our healthcare system. These nurses include SAS’s Sister Peh Woon Bin and Sister Ng Ah Muay, both in their 70s. They are pioneers themselves, and have spent the last decade providing care to fellow Pioneers and mentoring younger staff nurses in their work. They have shared that they continue to serve with SAS because of the satisfaction and fulfilment they gain from their professional caregiving roles and direct contributions to the society. I thank all nurses for their dedication and their commitment. I wish all nurses a very happy Nurses’ Day.

Conclusion

17.       In closing, I would like to congratulate the management and employees of SAS on the official opening of their new tower block today. I wish the Home every success in its operation and together, we can provide more and better care for our seniors.

18.       Thank you.