SPEECH BY MR LIM BOON HENG, MINISTER FOR PRIME MINISTER'S OFFICE, AT COMMITTEE OF SUPPLY 2009, 06 FEBRUARY 2009, 3:30 AM AT PARLIAMENT



Introduction


Mr Chairman Sir, I thank the members for their strong support of the elderly. The voices that they have put forward on behalf of the seniors is commendable, and I hope that the whole generation of younger Singaporeans will listen to them. We know we are all growing old, and Singapore is ageing fast. And although during this time, there is a tendency to put this aside because of other pressing issues; I think we should still take the opportunity to prepare ourselves for the much larger numbers of seniors we are going to have.

2. Mr Sin Boon Ann requested for an update on the efforts that we have made to prepare for ageing. I will first cover financial security.

Work Longer, Save More

3. In recent years, the Government has focused on helping Singaporeans to work longer and save more. This is necessary because we are living longer. CPF LIFE will be implemented from 2013. The Workfare Income Supplement scheme has also been refined to better support older lower-income workers. For workfare, seniors get more. Retraining and upskilling opportunities have been expanded.

4. Our tripartite partners have also been actively promoting re-employment before it is legislated in 2012. As Ms Cham said yesterday, 706 unionised companies have committed to re-employment, with about 5,400 workers (above 62) already being re-employed in October 2008. Some have not had their contracts renewed, so the number fell to 4,650 in December. Our employment rate for workers aged 55-64 years is 57% today. And, we will still work towards the target of 65% by 2012.

5. Ultimately, we should build a culture where seniors are engaged in purposeful and fulfilling work, for as long as they are able. More Singaporeans are sharing this view. According to a global survey by insurer, Aviva, 6 in 10 Singaporeans would like to work beyond the retirement age. This is the second highest rate in the world after Hong Kong.

6. We must however accept that working longer does not equate to working in the same job, in the same organization, at the same pay. The seniority-based wage system, which has been with us for decades, is a barrier against continued employment. Under this system, it might cost employers less to recruit and train a fresh employee than to retain an older worker. Ultimately, pay has to be based on the value of the work produced. Thus the terms of re-employment have to be negotiated. And unions and employers are doing so. Workfare, as I have said, favours senior workers and should be taken into account.

7. I agree with Mr Sin that we should help the elderly find jobs that are less physically demanding and more meaningful. But there are practicalities and sometimes, it is unfortunate that the only type of work that an elderly person can do is the type he described. Nevertheless, we should try and find meaningful work for seniors. In the US, the concept of an “encore career” has been embraced by baby boomers there. These new careers in the second half of life are usually in the social arena, and provide meaning, self-fulfillment and also, income. This is an area where I think Ms Ellen Lee has been speaking up on behalf of seniors – an area where seniors can be gainfully engaged. Today’s economic environment also allows for experimentation with flexible work arrangements that meet the aspirations of our seniors.

8. However, we should not deny seniors of work which may be more physically demanding. If seniors want to and are able to work in these jobs, we should encourage them to. It keeps them active and self-reliant. I have often been cheered by the impeccable service provided by older staff at fast food counters.

9. Let me turn next to the community.

Building an Age-friendly Community

10. Hardware-wise, we have made good progress in building an age-friendly community. We are on track for all HDB precincts to be barrier-free by 2011, and for lifts to be at every floor by 2014. Within five years, community clubs and RC centres will have basic barrier-free features.

11. To expand the range of housing options for seniors, HDB is building more studio apartments, two-room and three-room flats. Seniors wanting to encash their housing assets have more options. For seniors living in smaller flats, we are implementing the lease buyback scheme this year.

12. Hardware must be backed up by software, so that our community is not just a pretty but empty shell.

13. Far too often, we read about seniors and their families struggling to cope with mental illnesses. Last month, Mdm Voon, who has mild dementia and depression, went missing in Genting. We are happy for the family that she was found in Singapore a week later. But there have been other cases where seniors with mental illnesses die alone and unnoticed, abandoned by their families and shunned by their neighbours.

14. As a society, we need to be more aware of mental illnesses among the elderly. At times, the stigma and misperceptions are worse than the illness itself. We must address this early, if we are to manage them well in an ageing population. The incidence of dementia, one form of mental illness, is expected to rise sharply. Within a decade, 45,000 seniors are projected to have dementia, double the number today. They will make up 8% of the elderly population.

15. Resources have been allocated to improve public education, prevention, detection and early treatment of mental illnesses. Late last year, the Community Psycho-Geriatric Programme commenced training of grassroots volunteers in early detection and follow-up of suspected cases. More than 400 grassroots leaders and frontline staff from CPF Board and town councils will be trained this year.

16. We should not just rely on grassroots leaders and community touchpoints. At the end of the day, families, friends and neighbours are best placed to care and support our seniors.


17. In line with this, the People’s Association has made “neighbourliness” a central theme in its workplan. It has launched a Neighbours Connect programme to build social networks within each RC. We target for at least 200 RCs to implement the programme over the next 5 years.

18. Small acts of kindness go a long way. About two years ago, one of my former colleagues, Ms Debbie Ng, was discharged from hospital after a knee operation. As her daughter had to work in the day, Debbie had considered admitting herself to a community hospital for rehabilitation. But when a neighbour heard of her situation, she immediately offered to help Debbie in the day by cooking some simple meals. There is nothing better than being able to recuperate in the comfort of your own home. And there are no hospital bills to pay!

19. Neighbourliness is another reason why we are piloting the Wellness Programme in 12 constituencies. The programme helps residents aged above 50 to better manage their health and to be engaged with others through social interest groups. Residents assessed through health screenings to be at-risk will be referred for follow-ups. Through the pilot, we will develop a model which we hope to introduce to other constituencies next year. While the focus is on the seniors themselves, we are also hoping that this programme will promote intergenerational bonding. And in the pilot programme, there are examples of younger people from the schools working with seniors. The respect that we want the younger generation to have of seniors can be transmitted through such joint activities.

20. 60-year-old Mr Ho Toon Fang has benefited from joining Wellness@Punggol South last year. Mr Ho used to stay at home and barely exercised. Today, he is a regular user of the gym at the Wellness centre, and has found friends with common interests. Last December, he was part of a group that called themselves “OCBC - Old Can Be Contributing”. This group of seniors collected newspapers together with students to raise money for needy residents. I hope that more such stories of healthier and active seniors will arise through the Wellness Programme. And as this example shows, young students are involved, and so those values which the older generation has will be transmitted through this activity.

21. Neighbourliness is also key to healthy lifestyles. Last year, I announced that MOS Heng Chee How will study ways to promote physical activity among older Singaporeans. It is well known that regular physical activity is essential to our health and well-being. It even reduces the risk of mental illnesses and some types of cancer. The problem is that not enough people do it.

22. One lesson that Mr Heng and his team have learnt is that physical activity is best promoted and sustained through social groups. Finland has only 5 million people. But it has 9,000 sports clubs, run mostly by volunteers! Can we do the same at our grassroots, among neighbours? We are now working out how briskwalking and taichi, already popular activities in the community, can be better promoted. I know that Dr Teo Ho Pin would like more money to be provided for briskwalking. But, I put it to him that it is an activity which should come from the ground; and we should not need to spend so much money to motivate people to do this activity.

Supporting our Caregivers
23. Even with all our efforts to promote healthy lives, some of us will fall sick, become frail and require care. We project that the number of seniors needing help with activities of daily living will double to 65,000 over the next decade. For these seniors, most of them will look to the family. Mr Chiam See Tong and Ms Ellen Lee both spoke on the need to provide greater support for caregivers.

24. Caregiving is an important and, at times, stressful task. As family size becomes smaller, the burden on caregivers will also rise. The Government will look to ensure that caregivers are given the support they need to carry out their responsibilities.

25. Caregivers should be provided better information and guidance on care options. For seniors discharged from hospitals, the Agency for Integrated Care helps families to coordinate the appropriate services required to support the senior within the home and the community. We have to be more senior-centric and provide services across the medical and social care continuum in an integrated fashion.

26. We will also look at expanding caregiver training and support programmes. Today, families can tap on subsidies under the Caregiver Training Grant to attend caregiver training courses. We will raise awareness and availability of these courses. Some of these courses can be accredited to the Workforce Skills Qualifications framework, so that these caregivers can also find employment in the eldercare sector, something that Ms Ellen Lee hopes to see.

27. More services will also be introduced to provide more options for caregivers. I am pleased to announce that MCYS will fund the building of six new day care centres for seniors over the next five years. Day care centres provide care and keep frail seniors socially engaged. They also provide respite for family caregivers. We are improving maintenance exercise programmes at these centres, so as to keep our seniors physically and mentally active.

28. Going forward, the Ministry of Health will enhance the provision of services in the Intermediate and Long-Term Care sector, which it will elaborate on later. Even for those without family caregivers, seniors should be supported to live as long as possible in their own homes.

29. Among the more vulnerable seniors are those living in HDB rental flats. Today, there are 19 Seniors Activity Centres serving seniors in one-room rental flats. Operated mainly by Voluntary Welfare Organizations, they provide basic information and referral, organize social activities and engage homebound seniors. Over the next five years, MCYS will also fund the set up of about 22 Seniors Activity Centres and expand some of the existing SACs. Working hand in hand with the local grassroots, the SACs are part of the social safety net for vulnerable seniors.

30. Overall, MCYS will spend an additional $18 million on these Day Care and Seniors Activity Centres.

Long-term Care financing

31. Mr Chiam and Ms Ellen Lee also mentioned financial assistance for caregivers. I am mindful that other members of this House have previously called for an allowance for family caregivers. I have said that we should not inadvertently monetize family care and responsibility. Nonetheless, we will take a look at this issue in the context of financing long-term care.


32. All around the world, countries are grappling with how to finance long-term care. One issue is to manage the rising demand for long-term care services. Another is that long-term care services tend to be more fragmented than medical care, and therefore not as cost effective or as “person-centric”. Long-term care is also expensive, requiring us to examine who pays for the care. There is growing consensus that national policies should not prescribe the form of care, but should allow personal choice.

33. Last month, there were visitors from overseas who shared their experiences and said that the greatest mistake that the United States made was to build so many nursing homes - that became the automatic option of choice which is very costly, and something which they now find difficult to unwind. They suggested to us that we have the opportunity to keep people at home because of the nature of our housing. We have a public housing programme that no other country has, which provides us with the elements to build support services for the elderly around that framework. We will study accordingly.

34. In most OECD countries, total long-term care expenditure average 1%, but can be as high as 3% of GDP. Welfare states, in particular, find that they have to ration services to contain public expenditure. The UK is now considering a mandatory private insurance scheme for long-term care, a radical departure from its state-funded health service. We have to understand these models better as the devil is in the details.

35. We are not starting from scratch. Eldershield provides a good basis from which to refine our long-term care financing mechanisms. Eldershield was reformed in 2007 to provide higher payouts of $400 per month for up to 6 years. Supplements are also available to provide higher payouts or longer periods of payout, or both.

36. In the same way as how our 3Ms – Medisave, Medishield and Medifund – cover medical care, we will need to look at whether to set up a parallel of having 3Es to cover long-term care expenses. The 3Es being Eldersave, Eldershield and Elderfund. Or maybe it is possible to enhance the 3Ms. Together with means-tested government subsidies, which are available for most care services today, we want care in old age to be affordable for all Singaporeans. The Government will study how such a financing framework can be more holistic and robust.

Optimism in Active Ageing

37. While we set about to deal with the challenges arising from an ageing population, we must not forget that the extra years we have is also a blessing. How can we help seniors add life to years?


38. We want to enable older Singaporeans to lead happy, healthy and active lives. Our efforts on employment, financial security, ageing-in-place, health and long-term care will go a long way to achieve this vision. Changing our attitudes about ageing is also important.

39. An international survey conducted by AXA tells us that retirees in Singapore tend to think 70 is old. On the other hand, retirees in the US perceive being old with the age of 78. The irony is that the US life expectancy is lower than Singapore! The boxer Muhammad Ali probably exemplifies this optimistic American spirit. He once said, “Age is whatever you think it is. You are as old as you think you are”.

40. Efforts to promote positive mindsets about ageing have intensified over the last two years. In 2007, the Council for Third Age (C3A) was set up by MCYS to champion active ageing. Last year, the CDCs partnered the Council to hold active ageing carnivals all over Singapore, greatly enhancing outreach efforts. As more seniors become active agers, we will certainly see them come out to contribute their time and expertise, at work and in the community.
41. Mr Baey Yam Keng asked if the Government should do more to encourage concessions and discounts for seniors. Certainly I will encourage commercial companies to do so. But, I think ultimately this must still be based on commercial considerations. Otherwise, the costs of concessions would fall back on the rest of society, and everybody else has to pay more. What we can do however is to encourage companies to see that being pro-seniors is also pro-business.

42. Let me offer an example. It is well known that NTUC Fairprice offers senior citizens a 2% discount on Tuesdays. It does this not just because of corporate social responsibility, but also to attract customers, since Tuesdays tend to be the slowest day of the week. Tuesdays are now one of the busiest days, alleviating the heavy weekend traffic at the supermarkets, and raising the yield per square metre of floor space used.

43. Part of the mission of the Council for Third Age is also to build a vibrant market for seniors in Singapore. Last month, it organized a 50 Plus Singapore Expo, which received an enthusiastic response from about 70,000 seniors. Special deals for seniors were on offer from the 150 participating companies, ranging from health screening to customized travel packages. And I believe concessions or special offers were provided to the seniors. Over time, I am confident that more companies will want to reach out to our increasingly affluent seniors.

44. But I take Mr Baey’s point that we should also encourage family packages so that the seniors can enjoy certain activities together with their grandchildren. And today, if you go to the cinema, there are concessions for weekdays, Mondays to Fridays, before 5 pm, but for seniors. So he’s right that we should encourage the cinema operators to give concessions so they can go together with their grandchildren. We should strongly encourage them to do so.

45. Ageing is a sunrise industry not just in Singapore, but all around the world. Our Asian hinterland dominates population ageing; the number of people aged 60 and above will quadruple to 1.2 billion by 2050.

46. For this reason, we want to develop Singapore as a knowledge and business hub for ageing. Let me give you some examples: EDB is leading efforts to develop the health and wellness industry in an ageing population. In January, two conferences – Reinventing Retirement Asia, and Asia Forum on Ageing – were held in Singapore, involving many international experts and partners. The Silver Community Test-Bed Programme under MCYS is into its second call for proposals to test-bed age-friendly products in HDB homes. Last year, SingaporeManagementUniversity, with the support of the Monetary Authority of Singapore, has set up a Centre for Silver Security to conduct research on retirement security in ageing populations. As we can see, Singapore is becoming a vibrant place for research and business on ageing.

Conclusion

47. Let me conclude by saying that the work of the Ministerial Committee on Ageing builds on previous efforts to prepare our population for ageing since the 1980s. There are still some major items on the agenda, such as long-term care financing and developing more care and community services for an ageing population. At the end of the day, however, each individual is responsible for preparing and living out one’s golden years, with the family playing an important supporting role.

48. Within the next two months, MCYS will be releasing a public report to update on what the Government has done to prepare for an ageing population. It will contain useful information and practical advice on how Singaporeans can prepare well, and how we can work, live and play in our later years. As we add years to our life, we should also add life to our years. I hope the report, titled “Adding Life to Years” would inspire all Singaporeans to be happy, healthy and active today and in the future.