Care for the Growing Elderly Population

Mr Christopher de Souza asked the Minister for Health (a) whether he would provide an update on how the Government will help create an environment to care for Singapore's growing elderly population; and (b) whether the Ministry would consider more home-based healthcare services or retirement villages as options for our elderly to age and be cared for gracefully.

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The Minister for Health (Mr Gan Kim Yong): Mr Speaker, the key role of the Ministerial Committee on Ageing is, indeed, to facilitate ageing-in-place, that is, to enable seniors to age gracefully and be cared for at home where they live for as long as possible.

In Singapore, the majority of our population lives in HDB estates. As such, as the HDB population ages, we already have "naturally occurring retirement communities" in our public housing estates.

The key challenge is therefore how to retrofit and integrate care services into our mature HDB housing estates to help seniors age in place. We aim to achieve this in a number of ways. First, we will make our flats and towns more senior friendly, such that seniors can lead independent, active and meaningful lives. The Marine Parade pilot project is a first step in this direction, where we are testing out intra-flat retrofits and improving town infrastructure to make it easier and safer for seniors to move around. The outcomes of our test bed at Marine Parade will help us devise strategies to scale just programmes to the rest of Singapore.

Second, we hope to diversify and enhance the range of care options, especially home help, home medical and home nursing services, such that seniors can be cared for at home even when they are frail or when they fall sick. As we enhance the range of home care services, we will also review our subsidy framework to keep home care affordable. We will also look into ways to enhance centre-based services, such as day rehabilitation facilities and locate them conveniently in the community for better accessibility. Notwithstanding, we recognise that there will still be seniors who may require more intensive care at least for certain periods of time. Therefore, we will also continue to enhance institutional care such as nursing homes, especially for those who need such services.

Third, we want to support those who care for seniors in the homes. We hope to step up efforts to empower caregivers with the proper skills and make respite care, emergency services and counselling support services more accessible.

Our society will age significantly over the next 10 to 15 years, and we need to start to invest in infrastructure and services now to support ageing in place as the need for aged care will grow in the future. The Ministerial Committee on Ageing aims to release a masterplan sometime next year, which will detail initiatives to facilitate ageing-in-place. The Committee will work with various stakeholders to achieve our vision of making this a city for all ages and one which empowers seniors to age in place. We need to work with the private sector and voluntary welfare organisations to scale up our services and to professionalise aged care. We need to work with grassroots organisations and VWOs to outreach and support seniors, especially those who may live alone and have no children to support them. Above all, we need to work with all Singaporeans to support, care for and be gracious to seniors living among us.

Mr Christopher de Souza (Holland-Bukit Timah): Sir, I thank the Minister for his comprehensive reply. I have two supplementary questions. The first is, given the manner in which the population demographics is going to change in favour of the number of seniors in Singapore over the next 10 to 15 years, would the Minister consider recruiting a lot more geriatricians for our hospitals and the specialist practices that come with the geriatricians? Secondly, the Minister mentioned respite care and help to support those who are giving care at home. Those are very local home-based support services. While I welcome them, would the Minister also consider community-based support that the elderly can go and receive therapy from each other in form of social interaction within communities?

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Mr Gan Kim Yong: Sir, the short answer to both questions is, yes. From the hospital's point of view, we will have to recruit more geriatricians as well as nurses and allied health professionals who provide physiotherapy as well as other related therapies. The medical support staff that will support our ageing population is an area that we will look at. Within the Ministerial Committee on Ageing, for example, there is a sub-committee specifically looking at manpower needs and manpower development to support our various infrastructure development that will be coming on-stream.

The second query on community-based support: yes, indeed, we are looking at how we can create more facilities within the community so that our seniors can go to for therapy, for treatment as well as for health screening. One of the initiatives which we recently announced was the setting up of community health centres where we provide therapy as well as health screening for our senior citizens, not just senior citizens but the population in general. Senior citizens will have better access to them because they are in the community and not necessarily in the hospitals. These facilities will help seniors who are cared for at home because in the day time they can go to these facilities for services or support.

In addition to homecare, as I mentioned in my reply, we will also continue to look at how we can expand the capacity for nursing homes because over time, we will also require more bed capacity for seniors who cannot be cared for at home and need to rely on institutional care. We are looking at different care options for our senior citizens so that we will have a variety of options that will suit the needs of different profiles of senior citizens.

Ms Tin Pei Ling (Marine Parade): I thank the Minister for the comprehensive reply and I am also heartened that there is a continuous strive towards achieving "ageing in place". But apart from putting in place a conducive environment, infrastructure and programmes to support the care for our elderly, the caregivers' ability to care remains important. We know that family support is probably one of the most preferred channels of care giving that we can give our parents. So with that, would the Government or the Ministry consider mandating or making annual leave provisions to Singaporeans to let them take care of elderly parents when they are ill and, perhaps, would the Government take the lead in such an effort?

Mr Gan Kim Yong: I think Ms Tin has put forward a very important idea of caring for the caregivers because these caregivers who are spending their time and effort, making sacrifices to look after their seniors, their elderly, their frail at home, it is important for us to ensure that they also receive the necessary support from the Government and from the community. That is why the overall masterplan for the Ministerial Committee on Ageing will also include how we can help and support these caregivers, providing some respite in terms of the services that are provided to them or in looking at whether we can provide them with more leave so that they can have more time to look after their elderly and frail at home. These are issues that will be discussed at the Ministerial Committee on Ageing.

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Ms Jessica Tan Soon Neo (East Coast): Mr Speaker, one question for the Minister with regard to the programmes. While the schemes are available and there will be improvements to the programmes, what is going to be done in terms of raising the awareness of what is available, especially for home-based care? I think there is very low awareness of home-based care from palliative to some of the ongoing care. That is an important aspect. The other aspect is: what measures will be taken to streamline the processing of available subsidies and schemes because some families struggle with understanding how to access these programmes?

Mr Gan Kim Yong: I agree that there is a lot more that can be done and ought to be done in terms of our outreach and in raising awareness among the public, especially those that need help for health care, especially among the older Singaporeans who have limited sources of information. In this regard the community organisations will play a very important role. Ministry of Health is working with CDCs as well as the community organisations to reach out to the residents who may need help. We are also working with the GPs on the ground to engage their patients who may need help and if you remember recently we announced the rolling out of enhanced primary care partnerships scheme (PCPS). Through the PCPS scheme we provide portable subsidies to these patients. We work through the GPs who are attending to these patients to ask them to apply on behalf of their patients so that they can benefit from some of the help schemes. Hopefully, by doing so we would then be able to reach out to more senior citizens.

We are also taking the opportunity at the hospitals: whenever they come to our hospitals or institutions for checkups or for medical treatment, we would also raise awareness about what schemes are available to them if they need help. We need to mobilise all our stakeholders, not just our Government hospitals but also private sector GPs and doctors as well as the community groups to help raise awareness. We are also looking at how we can streamline some of these processes. We do understand that many of these elderly are not very good in filling up forms so we will try to simplify the application process as much as possible. We will also work with our community, organisations and GPs to see how we can help them through some of these processes, help them navigate in our system so that they will be able to receive the help that they need.