HOME-BASED CARE

HOME-BASED CARE

18.

Dr Lam Pin Min asked the Minister for Health in view of the rapidly ageing population and the increasing demand for home-based care, what are the Ministry's middle to long-term strategies in developing this sector of healthcare in Singapore.

Mr Khaw Boon Wan: As a policy, we support the idea that all seniors should age at home, and not have to rely on long-term institutional care. The vast majority of the elderly are generally healthy and are able to age at home. A small minority will however require long-term medical or nursing care. Where it is not practical to provide such professional care at home, admission to a nursing home becomes inevitable. But we should try to avoid such an outcome as far as practicable. Where it is cost-effective to bring medical or nursing care to the patients at home, we should try to facilitate it. This is also the preferred option by the seniors as they can then remain in a familiar environment, and be in the company of their family members.

Currently, home healthcare is not a big part of our healthcare sector. But as our population ages further, we can expect the demand for it to grow. Thus, an important part of our strategy for home care is to ensure there is sufficient capacity in the sector to meet the growing demand. This means an adequate supply of healthcare workers, including doctors, nurses, therapists and other allied health professionals. We are ramping up their numbers through increased training and foreign recruitment. We will also need to expand the number of daycare centres, in tandem with rising demand.

Second, we will enhance the capabilities of our home care services. We will need to raise their professional skills and standards so that they are confident to care for the seniors in the community. My Ministry has now extended its support to the training and professional development of healthcare workers from the home care sector through the Health Manpower Development Programme. As the sector grows, we will increase funding for training in home care.

Third, we want to make home care more affordable through gradually extending the 3Ms framework to long-term care and home care. As a first step, we have decided to extend Medisave to cover home palliative care. As we gain more experience with this pilot, we will consider how the scheme can be further extended to other home care services.

Fourth, we will work with the home care providers to improve the coordination of the various home care services, as well as the integration of home care with primary care and hospital care. We will link up home care providers with the GPs, polyclinics and the hospitals, so that there will be less hassle as patients move from one care setting to another. Without coordination and integration, the patients and their families are often at a loss as to how to access the relevant services. The objective is to care and support the elderly with more complex care needs, so that they can stay at home for as long as possible. We have begun discussion with the Home Nursing Foundation on this idea as we think that it can play an important role in the transformation of the home healthcare sector.

Finally, we need to ensure that caregivers are well trained to cope with the physical and socio-emotional needs of the elderly. We provide a Caregiver Training Grant to help caregivers participate in such training programmes. In addition, we are currently studying the need to provide structured skills training for foreign domestic workers as they often are critical members of the caregiver team.

Home care is a focus area of MOH. There is much that we need to do to beef it up. Our population is still young, but we will have to start to put the various pieces in place to prepare for a more elderly population in the future.