Singapore Government Press Release

I am very happy to be here this morning to officiate at the opening of the 1997 World Congress of Gerontology Singapore Satellite. Many of you have come from abroad for this conference. I bid the visiting delegates a very warm welcome, and I hope that you will have an enjoyable and productive stay in Singapore.

Many countries in the world today, especially the developed countries, are faced with the challenge of an increasing number of elderly in their population. Singapore, too, faces this challenge.

Today, Singapore has about 210,000 people above the age of 65. They make up 7% of our total population. By the year 2020, we will have about 530,000 elderly, or 13% of the population. This is an increase of 320,000 elderly over a period of some 25 years. What is worrying is that, arising from the post-war baby boom, the number of elderly will increase even more rapidly after that. Between 2020 and 2030, ie, within a period of only 10 years, our elderly population will increase by 270,000 to total 800,000. They will then make up over 18% of the total population.

The Singapore government recognises that the challenge of the elderly is a multi-faceted one. It has complex social, economic and health dimensions. What makes the challenge even more difficult is that the issues are not manifestly evident today. Ageing is a gradual, imperceptible process. In fact, many younger people tend to think they will be forever young, and put off efforts to prepare for their eventual old age.

Recognising the complexity of the issue, we have in recent years put in place several programs to meet the needs of the elderly. These current efforts are by no means comprehensive. They will have to be enhanced and modified in the years ahead, in keeping with the growing number of elderly.

Let me mention some key initiatives that demonstrate Singapore’s commitment to positive ageing.

Firstly, the perception or attitudes towards ageing. In youth-oriented societies, people tend to perceive the elderly as being sickly, dependent and decrepit. These perceptions are far from the truth. For example, some 93% of the Singapore elderly are ambulant and relatively healthy.

We have public education programmes to encourage Singaporeans to cherish and respect our elderly. This includes setting aside a Senior Citizen’s Week every November, where many events involving the elderly are organised throughout the country.

However, the elderly themselves also have to play their part towards getting others to view them positively. They have to overcome the tradition of having to "act their age" – where they are expected to be less active, and be helped by younger people in every little thing. On the contrary, they should continue to play an active role in society, maintain positive relationships with their families, and lead active, healthy lifestyles.

Towards this end, many larger organisations now organise regular retirement planning seminars for their older staff. Various grassroots and community organisations also organise social and recreational activities to keep the elderly physically and mentally active.

Secondly, the issue of employment. Employment gives the elderly person a sense of worth, dignity and financial independence. It also enhances his social support system and relieves boredom. With effect from Jan 1999, we will be raising the retirement age from 60 years to 62 years, with the longer term plan of eventually raising it to 67 years.

Thirdly, we try to keep the frail and sick elderly in the community and with their families for as long as possible. It is difficult for institutions to replicate the warm emotional environment and support of their own family settings.

In order for the frail and even the sick elderly to remain in the community, my Ministry is working hand in hand with many VWOs to establish a wide range of community-based services. These would include day care centres, day rehabilitation centres, befriender services, home medical, home nursing and home help services. There are also organisations providing respite care to relieve family carers, and we are now having pilot home modification programmes to make homes more elderly-friendly.

This approach of harnessing the spirit of compassion and voluntarism of the community and combining it with professional and financial assistance from the Ministry has helped to provide a high level of service at an affordable cost.

Some elderly will require long-term residential care in nursing homes, either because their families, particularly those from dual-career families, cannot cope with the high level of care needed, or because of poor family relationships. We currently have 46 nursing homes in Singapore, half of which are run by VWOs, and the other half by commercial organisations. They provide 4,400 nursing home beds. We expect to have 7,000 nursing home beds by the year 2000. This should adequately meet our needs.

The healthcare requirements of each individual elderly will change over time. The elderly should be able to move seamlessly from one type of service to another. This would ensure that each elderly sick is being provided the most appropriate and cost-effective level of medical care. It benefits both the patient in terms of the convenience and appropriateness of care, and the nation as a whole in terms of optimal use of scarce resources.

To achieve this, we have divided Singapore into three geographical regions. Each has its own integrated network of geriatric services, comprising an acute geriatric service in the regional hospital, a community hospital, nursing homes for extended stay, day centres, and various home care programmes. We are now training the whole healthcare team for the elderly, including GPs, therapists, nurses and nursing aides to provide the necessary services.

There are however many issues of ageing, be it social, financial or emotional, which are not well understood. We also need to identify the most efficient and effective way of meeting the healthcare needs of the elderly.

In recent years, efforts have been made to better understand some of these issues. For example, several projects have been undertaken to study the health problems of the elderly. These include investigating lifestyle factors that could affect the health of the elderly, functional states of elderly people, vision problems (for example cataract and glaucoma), and other medical problems.

But more can and should be done in the next few years to research into issues related to the elderly. We cannot afford to defer such research activities for too long, as the problems facing us by then would be of much greater magnitude. This is being addressed by the provision of research funding. Gerontology, being one of the areas of concern in Singapore, will be eligible for funding consideration.

However, my Ministry appreciates that doctors are employed primarily to provide clinical service to patients. They are not given the time to carry out research, because to do so would affect the level of care to patients.

In this regard, I am glad to report that we are taking steps to rectify this problem. The National Medical Research Council has budgeted $50 million to be used to reimburse public hospitals to give "research time" to their doctors over the next 5 years. This reimbursement will be used to employ additional doctors who will take over the clinical duties so that service provided by the hospital as a whole is not affected.

This would enable about 5% of full-time equivalents of doctors in the various hospitals and institutions to be actively involved in research work. Our target is to eventually fund up to 10% of doctors for medical research. I encourage all doctors to come forward to undertake more medical research, including gerontological research, now that more financial assistance is available.

The challenge of an ageing population is one that faces all of us. The only difference separating us is timing. Most of the developed countries are further down the road in terms of the proportion of elderly in the population and its rate of increase. But those countries with younger population will also eventually face this challenge.

There is a tremendous pool and range of experiences available around the world. There is much scope for the sharing of such experiences, and to minimise the need to re-invent the wheel. We welcome this opportunity for mutual learning. We would be happy to cooperate with the International Association of Gerontology to promote gerontological research and to provide training for professionals involved in looking after the elderly. By working together, we can optimise on the use of the limited resources in each of our countries, while catering to the needs of the elderly as best as possible.

With that, let me end by wishing all participants an enjoyable and productive conference.