The Official Opening Of The Lions Home For The Elders

13 Jan 2003

By Mr Lim Hng Kiang

Venue: Lions Home for the Elders (Toa Payoh)

Introduction

I am very happy to be here today at the opening of the Lions Home for the Elders (Toa Payoh). First, let me congratulate the Lions Clubs of Singapore on this special occasion. The opening of this Home not only reflects your strong commitment to caring for the elderly sick, it also demonstrates how community organisations, such as the Lions Clubs, can work hand in hand with the government to provide a range of health care services to meet the needs of the elderly.

Lions' Heritage

The Lions Clubs currently run a 154-bedded nursing home at Bedok South, which was opened in 1997. However, Lions have been involved in the care of the elderly for more than 2 decades. Its first community Home for the aged destitute and older persons was started in January 1980. Situated at a Housing and Development Board void deck at Ang Mo Kio Avenue 10, it was a modest start, providing free lodging for 18 residents.

Lions' second home, which was located at this very site, started in November 1985 using a converted World War II bomb shelter. The Home catered to 45 residents. In 1997, the Toa Payoh Home was torn down for redevelopment. Today, we are here at the opening of the new 200-bed Toa Payoh nursing home which apart from providing nursing home care, will include a 40-bed dementia wing and physiotherapy/occupational therapy centre.

Together with the 154-bedded nursing home at Bedok South, the Lions Clubs will have a total of 354 nursing home beds under its wing. For these 2 nursing homes, Lions will have over 160 staff, an average of one care staff to 2 patients.

Manpower Development in Nursing Homes

The provision of nursing home care is very manpower intensive. It involves taking charge of frail elderly, who need assistance in daily activities of living - personal hygiene, toileting, bathing, transferring and feeding, in addition to nursing and caring for the patients' medical, emotional and social needs. There is relatively limited scope for manpower substitution or automation as nursing home care is 'high touch' care. You cannot use a machine to dress a wound, bath or change a patient. Thus, attracting and retaining good staff is crucial to ensure the quality and standard of care. With an ageing population, the demand for trained staff will increase. We therefore need to put in place a holistic package of measures to facilitate manpower development.

Today, nursing homes rely heavily on unskilled staff. Less than 20% of the professional staff are trained nurses while the rest are relatively unskilled workers. While the shortage of nursing and skilled healthcare workers is not peculiar to the step down care sector, we need to take active steps to attract, retain and upgrade the various categories of staff in these facilities, so as to improve the quality of care provided. Today, I would like to highlight 2 key areas, how to improve training and enhance professionalism.

Need to Step Up Manpower Training

Firstly, manpower training. We need to step up staff training efforts in our step-down facilities. Currently, the average expenditure on manpower training in MOH funded nursing homes is only about 1% of the manpower costs. This relatively low expenditure on staff training can be attributed to the large proportion of foreign workers who are on short term contract.

Another reason is funding. The Government subvents the service providers for their operating expenditure, which includes training expenditure. But since training expenditure is low, the subvention component is correspondingly low. Another approach is to provide specific funding for skills upgrading or training, in particular for medical, nursing and allied health professionals like physiotherapists and occupational therapists, and medical social workers.

New Health Manpower Development Programme for Step own Care

To assist the service providers, from 1 April 2003, my Ministry will extend the Health Manpower Development Programme (HMDP) to Step Down Care.

We will set aside $3.3 million for the next 3 years. We envisage that at least 90 staff from step down care services, such as community hospitals, chronic sick hospitals, nursing homes, hospices, day rehabilitation centres and home care services, will benefit from this fund. The staff could pursue training or skills attachments at local or overseas health care institutions, in areas identified to be of high priority for the improvement of care delivery. Trainees must be Singapore citizens or permanent residents.

Under the Programme, my Ministry will fund 75% of the approved training expenditure while the VWOs co-fund the remaining expenses as the trainee, upon completion of the training, will be required to sign a bond to work with the VWO. The duration of the bond will depend on the length and the location of training. In addition, to ensure that patient care is not disrupted, MOH will provide financial assistance, of up to 75% of the salary of temporary staff who would need to be employed to cover the work of the staff who has been sent for training. To encourage training attachments in local healthcare institutions, such as the public hospitals, for between one to three months, my Ministry will fund 100% of the salary of the temporary staff.

Other Training Initiatives

Apart from financial assistance, my Ministry will also put in place other training initiatives for the step down care sector. We will facilitate and bring in overseas experts once or twice a year. MOH will drive and fund the programme while service providers can help identify and prioritise their training needs, so that the appropriate experts could be brought into Singapore.

For this year, my Ministry will be conducting 2 workshops. The first workshop will be on dementia care to be conducted by experts from Australia. Dementia is a growing problem in a society with longer life expectancies, and we must ensure that our care staff are well-equipped to manage dementia patients. Secondly, my Ministry will be working with the National HealthCare Group to conduct a 3-day workshop on case management for about 40 participants. Community case management services help to improve the quality of life of the elderly by working closely with the elderly and his family through the assessment of the long term care needs, advice on services and assistance in placement into appropriate services.

Lions's Training Efforts

On the ground, the VWOs are also taking the initiative to provide training for their staff. I have been informed that in November 1998, the Lions Home was awarded On The Job Training (OJT) Centre status by the Institute of Technical Education (ITE). It is the first nursing home to be certified as an OJT centre. With this, the Home is required to have a structured training programme in healthcare and home care for all its staff. With a high percentage of the care staff coming from foreign countries, the Home ensures that all new staff are put through a training programme before they start working in the wards.

I am happy to note that the Lions Home is now planning to provide training for other nursing homes in Singapore. It was accorded an Approved Training Centre (ATC) status in July 2001 by the Institute of Technical Education. My Ministry has provided $8 million for the capital cost of the building and equipping the home. The Lions Clubs raised another $4.3 million to include additional training facilities so that other nursing homes can also benefit from their services. I would like to congratulate and commend Lions Clubs for this initiative.

Professionalisation of the Manpower

The second key area which will be addressed to attract, retain and upgrade staff is that of enhancing the professionalism of step-down care workers. In the year 2000, my Ministry established the Step Down and Elderly Care framework to make step down care more integrated and seamless for patients, as well as to assist step down care providers to upgrade the professionalism of their staff and services. I am very happy to note that VWOs themselves are also making good efforts in this area. Let me commend the initiative taken by 4 VWO nursing homes that have formed a workgroup to look into ways to 'professionalise' and raise the standards of the eldercare manpower sector through restructuring relevant services and jobs, and improving work conditions and environment thereby attracting better skilled locals to take up the jobs. The nursing homes are Lions Home,Thong Teck Home for Senior Citizens, Man Fut Tong Nursing Home and St Joseph's Home. The project will examine the current work processes in the nursing homes, identify priorities for job re-design, propose systems and changes to support the work redesign, and training to effect the transition. The project is still in its infancy and the plan is to roll out the programme in mid 2003. My Ministry supports this initiative and I would encourage other step-down providers to participate in this effort.

Government's support for VWOs

In conclusion, my Ministry is happy to be a partner with the Lions Clubs in the development of this new nursing home. Apart from the capital grant of $8 million, we will also provide about $1.2 million annually in the form of subsidies for the patients admitted to this Home. The Government can help to provide the hardware. But caring for the elderly sick demands a high level of motivation and compassion. VWOs, with their spirit of altruism and supported by a network of dedicated volunteers, can provide the 'heart' that gives that additional touch so well appreciated by the patients.

Once again, my warmest congratulations and best wishes to The Lions Clubs on the opening of the new nursing home. I now declare the Lions Home for the Elders (Toa Payoh) open.

Thank you.