SPEECH BY MR MASAGOS ZULKILFI, SECOND MINISTER FOR HEALTH, AT THE HEALTHIER SG WHITE PAPER DEBATE 2022, ON WEDNESDAY, 5 OCTOBER 2022

Mr Deputy Speaker Sir,

EMPOWERING RESIDENTS IN LEADING HEALTHIER LIVES

We have reached a critical point in Singapore’s demographic history. One in four citizens are expected to be aged 65 and above by 2030, up from one in six today. 

2. While our life expectancy is one of the highest in the world at 85 years, our health-adjusted life expectancy is 75 years. This means that on average, we spend about 10 years in ill health. Our chronic disease prevalence rate has also risen. The proportion of population with high blood pressure has increased from 20% in 2010 to 32% in 2020, and 26% to 37% for high blood cholesterol. 

3. We want to reverse these trends and empower residents to lead active and healthy lives, surrounded by people whom they love, and can support them in their journey towards better health. 

4. We must not let our health be determined by medical care alone, even if there are plentiful experts who can provide it. In fact, the way we live, work and play, and the environment we put ourselves in are as important, if not more so. 

5. We are already familiar with keeping healthy. From young, Singaporeans participate in activities in schools, such as physical education (P.E.) And go on to participate in programmes and activities in their workplaces and in the community.

6. During our engagements, residents have told us that they are better able to sustain healthy behaviours if it is social. Much like in school – among friends. For example, some find joy in going brisk walking with their friends. Others are motivated to stay healthy so they do not burden their family members. 

7. One resident said “Exercise and sports, I do a lot of that. I play pickleball. If I’m not playing games, I’m going for walks with my friends.” Another resident said, “If a doctor recommends me to do something, I would convince him that I rather do it with my friends.”

8. Like both residents, we are more motivated to exercise if our friends and family encourage us to do it, or better yet, to do it with us. 

BRINGING COMMUNITY PARTNERS TOGETHER 

9. Healthier SG acknowledges the importance that we place on participating in activities we enjoy, with our loved ones and friends.

10. In support of this, community partners will provide a range of lifestyle programmes and activities to attract different profiles, and bring them closer to residents’ homes, especially for our seniors. SPS Rahayu has touched on the Health Promotion Board’s (HPB) support for this. 

11. The People’s Association also has a wide array of health and wellness lifestyle activities, interest groups, and courses catering to a broad range of preferences and interests. 

12. Those who prefer more structured support can start with Sport Singapore’s network of Active Health Labs and Coaches. Active Health Labs will help residents get started and stay on their health regime. Residents will receive regular health and wellness coaching and advice on exercise customised to them in order to meet health goals. This includes residents who are at risk of developing chronic conditions.

13. Even before Healthier SG, we are and will continue to be inclusive in promoting health to all. Ms Denise Phua and Mr Mark Chay asked about the Ministry of Health’s (MOH) plan for persons with disabilities. The Enabling Masterplan 2030 which was just published in August sets out our approach to enable persons with disabilities to live healthier lives, supported by quality healthcare. 

14. Mr Gerald Giam asked about MOH’s upstream efforts on child and maternal health. 

15. Child and maternal health is critical. We have already started on this, in parallel with planning for Healthier SG. The inter-agency Child and Maternal Health and Well-being Taskforce that I chair focuses on improving health outcomes for our women and children, starting from as early as the pre-conception stage and during pregnancy, to give every child a good start. Expecting and postpartum women can access educational information and resources on Parent Hub which can be found on HealthHub.

16. Ms Denise Phua also asked about upstream interventions. We will continue to inculcate healthy habits from young by making health more prominent in schools and preschools and have started a review with the Ministry of Education (MOE) and Ministry of Social and Family Development (MSF) on this, so we can better support the health and development of our children.    

17. I have heard our concern for care and outreach to seniors, including males. Ms Ng Ling Ling suggested to partner family doctors with community partners. 

18. These suggestions are important as we shape Healthier SG. We will need to ensure family doctors are plugged in to relevant community level information so that they are familiar and can refer residents to these programmes. But more importantly, we hope their doctors can help them follow through on their health plans, and show how these achieve good health outcomes.

19. Therefore, we will strengthen coordination and support across partners. 

20. First, Healthy 365 as the entry way for all residents to easily access lifestyle programmes offered by community partners. Ms Ng Ling Ling suggested making it easy for more seniors to use Healthy 365 and HealthHub. I would like to assure her and other MPs that seniors who need help navigating the app and enrolment need not worry. Help is available at our community centres, Eldercare Centres or through our Silver Generation Ambassadors. Already, out of those 50 years old and above, 280,000 participate in National Steps Challenge™ on Healthy 365. There are also about 230,000 seniors above 55 who are using HealthHub. We will outreach to more seniors and ensure they will be able to easily navigate the apps and locate the information they want. 

21. Second, our healthcare clusters as regional health managers will step up. Ms Denise Phua and Mr Sharael Taha asked about the role of regional health managers. They will build relationships, coordinate activities and support across community partners and tailor programmes specific to the needs of the population in their region. Over time, healthcare clusters will gain in-depth understanding of their residents’ needs. They will work with partners to strengthen the environmental and social support for our residents. 

22. The Agency for Integrated Care, a trusted partner of many community partners, will support this effort, integrating care across partners to better support residents.  

23. Mr Yip Hon Weng expressed concern that there may be duplicative efforts in screening by community partners and primary care. We understand the concern. SMS Janil will be sharing the care protocols that will guide screening done by family doctors and their care team. In addition, our healthcare clusters will guide supporting initiatives in the community. Over time we hope to minimise duplication, and target population segments that need more help. 

24. These partnerships will make it easy for residents to live healthily in their day-to-day lives and help connect residents to relevant programmes and services. 

SUPPORT FOR SENIORS TO AGE IN COMMUNITIES 

25. Mr Deputy Speaker Sir, let me now elaborate on how we are supporting our seniors. 

26. We are committed to enabling seniors to age and live to their fullest potential in the community.  

27. The Ministerial Committee on Ageing (MCA) adopts a whole-of-society approach towards making Singapore a better community to age. This is one instance of a whole-of-society approach in health which member Ms Sylvia Lim said we should have.

28. In 2015, MCA launched the Action Plan for Successful Ageing, covering 70 initiatives across 12 areas. 

29. I am glad to share some key achievements from the Action Plan, and the latest initiatives on how we have built communities of care around our seniors. 

30. Today, active ageing programmes exist in every neighbourhood. Our seniors have opportunities to learn new things and meet new people close to their homes.   

31. We provide targeted outreach to those who need it through the Silver Generation Office (SGO), and with intermediate and long-term care (ILTC) partners. Since April 2022, at their door-to-door preventive health visits to seniors, SGO looks out for seniors’ frailty status and level of social support. They will intensify outreach to seniors identified to have higher health and social risks so that they can be referred to the right services. 

32. Dr Wan Rizal will be glad to know that we have been enhancing our care infrastructure and capacity to support the growing needs of our population. Helping seniors to age in the community, including those who are less mobile or immobile. Between 2012 and 2020, we added around 6,000 day care places and 5,500 home care places to cater to seniors with a range of care needs. Transport is provided to seniors who need it. 

ASSISTING THE VULNERABLE

33. Healthier SG will extend to all seniors, including those who are lower-income. I appreciate Mr Xie Yao Quan for raising concerns about the lower-income in Healthier SG. 

34. Preventive care is not only for those who can afford personal trainers and coaches. With Healthier SG, we are making preventive care accessible to everyone. 

35. We are collaborating with GPs and polyclinics to help residents stay healthier.  We are activating community partners to support them to live healthier lifestyles.  

36. Healthcare clusters have been working with social services agencies (SSAs) and MSF’s social services offices (SSOs) in their region to jointly address the health and social needs of the residents, particularly those from the lower income households. For example, there are community nursing posts co-located with many SSAs and SSOs to make health services more accessible at these community touchpoints. 

37. With Healthier SG, we will facilitate partnership and shared care of individuals across health and social agencies. We will also work through Primary Care Networks (PCNs) to strengthen the collaborations with Healthier SG General Practitioners (GPs). 

AGEING WELL AND CONTRIBUTING MEANINGFULLY 

38. All hands must be on deck to enable our seniors to remain physically, cognitively, and socially engaged, as well as maintain and improve their health. 

39. The MCA is refreshing the Action Plan for Successful Ageing. MCA ran a series of engagements with more than 5,000 residents. We found that many seniors continue to have aspirations even as they age, whether it is to volunteer in the community, care for their grandchildren or even start a business!  

40. We have concluded our recommendations and are finalising the report which will be launched early next year. The Action Plan Refresh will be anchored on Care, Contribution and Connectedness, what we call the 3 ‘C’s. 

a) For the Care thrust, seniors will be supported through preventive health, active ageing programmes and care services. 
 
b) On Contribution, seniors will have opportunities to contribute their knowledge and expertise to the community, by volunteering, continuous learning, and employment. Through our Citizens’ Panel on Contribution, many seniors have told us that they also wish to contribute to society by mentoring our youths. I am heartened to see such enthusiasm. 

c) Finally, for Connectedness, seniors will age-in-community within an inclusive built environment, while staying connected to their loved ones and society through digital platforms and support networks. As suggested by Ms Hany Soh and Mr Sharael Taha, we will increase opportunities for families to provide the support system to help our seniors live healthier lives, strengthening inter-generational relationships within the family.

41. The Action Plan Refresh will focus on interventions in the community. The Infocomm Media Development Authority (IMDA) and SGO help seniors to be more confident in using technology to stay healthy. For example, our Eldercare Centres have been collaborating with IMDA to hold digital literacy workshops for seniors. The Seniors Go Digital programme also helps introduce use of Healthy 365 and HealthHub. 

42. MOH has been working closely with the Ministry of National Development (MND) to develop new housing-cum-care options to support seniors to age in community. We launched our first Community Care Apartments – which are senior-friendly housing integrated with care services – in Bukit Batok last year. And we will be launching our second in Queenstown in the November 2022 BTO exercise. Housing monetisation options like the Lease Buyback Scheme are also available to support seniors to age in the community while boosting their retirement savings.

43. Eldercare Centres (ECs) will be further strengthened as the key node for seniors. ECs will be the go-to points for all seniors’ health-social needs, including connecting them to social and lifestyle activities and monitoring simple vitals. I would like to thank Ms Ng Ling Ling for her suggestion of reaching out to seniors living in private estates. Today, ECs provide support for seniors from different ethnicities and backgrounds, and many of them participate regularly in activities and programmes in ECs. When we double our ECs by 2025, we expect 8 in 10 seniors to be able to access these activities near their home.

44. We welcome more stakeholders and community partners to come together in this endeavour to build a society that empowers seniors to contribute, be socially engaged, and achieve their aspirations. 

45. All these efforts, together with Healthier SG’s emphasis on preventive care, lay a strong foundation for seniors to age in the community, a major reform of our aged care ecosystem. 

CLOSING

46. Before I conclude, let me summarise my speech in Malay: 

47. SG Lebih Sihat bertujuan untuk memperkasa kita semua untuk menjaga kesihatan.  Doktor keluarga akan bekerjasama dengan para penduduk untuk meningkatkan tahap kesihatan kita.  

Selain penjagaan kesihatan, kita akur faktor-faktor sosial dan persekitaran juga penting. 

Di bawah SG Lebih Sihat,  pertubuhan-pertubuhan masyarakat juga akan dilibatkan untuk menyediakan pelbagai program berdekatan dengan tempat tinggal bagi memudahkan penyertaan dalam program dan aktiviti untuk kekal sihat.  

Kami akan membantu warga emas meniti usia senja dan mencapai potensi penuh mereka dalam masyarakat.  

Pastinya  setiap individu mestilah mengambil berat atas kesihatan masing-masing, justeru mengambil langkah-langkah aktif untuk kekal sihat.  

Marilah kita semua memanfaatkan sumber-sumber yang disediakan untuk menjalani kehidupan yang lebih sihat,  dan sama-sama sokong-menyokong satu sama lain untuk berbuat sedemikian. 

48. In closing, the shift to leveraging community support for better health is a significant move. Everyone – families, individuals, community partners, and the Government – must and will do their part.

49. Together, we can help each other sustain healthier lifestyles. Live and age well. And be a Healthier Singapore.