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MCYS SPEECH NO: 13/2008

DATE OF ISSUE: 05/03/2008

Speech by Mr Lim Boon Heng, Minister, Prime Minister’s Office at the


MCYS Committee of Supply Sitting 2008, 5 March 2008, 4.15pm

The Minister, Prime Minister's Office (Mr Lim Boon Heng): Six
years ago, a book titled “Authentic Happiness” was published in the US. This
is not a typical self-help book. It was written by Dr Martin Seligman, who
served as President of the American Psychological Association in the 1990s.
He was known then for his work on depression. But when his young daughter
accused him of being a grouch, he decided to focus on “what made life worth
living”. Today, his book has been translated into 20 languages.

2 Seligman defines “Happiness” in three ways:


First, enjoy a pleasurable life - shopping, eating out, travelling and other
pursuits;
Second, enjoy a good life - being totally absorbed in work or hobby,
enjoying time with family and friends;
Third, enjoy a meaningful life - to pursue a cause that goes beyond the
self, such as community work, raising a family, teaching, and even politics.
The pursuit of happiness is fundamental to our existence. With an ageing
society, our Government’s objective is to help seniors live a happy, healthy
and active life.

3 To do this, we need to be free from financial worry - food on the table,


and maybe a little more to enjoy the finer things in life. This is why the
Government has devoted a lot of attention to financial security for seniors.
Last year, the Workfare Income Supplement scheme was introduced to help
lower-income workers save for old age. We will help more Singaporeans,
especially self-employed and informal workers, contribute to and benefit from
the scheme. And we have had a debate yesterday and today on this.

4 More recently, the CPF LIFE scheme was introduced, providing CPF
members with a steady, basic level of income for the rest of their life. Most
important of all, we have encouraged people to work as long as they can, and
for as long as they want. With income, there will be more money to spend.
We target to raise the employment rate of those in the 55-64 age group to
65% by 2012, from around 56% today. Public discussions have led people to
realise, and accept, that they have to work longer. Recently, a relative told
me she hopes to retire at 50, but wistfully says she cannot afford to do so.
She is a typical Singaporean. AXA, an insurer, has been conducting
international retirement surveys for several years. AXA’s most recent finding
is that Singaporeans hope to retire earlier than in other developed countries.
However, AXA also found that three out of four working Singaporeans would
like to hold a paid job after retirement. What it suggests is that Singaporeans
want control over what they do, such as doing a different job with flexible
hours or fixed shorter hours.
5 Several MPs have commented on the need to enhance the dignity of
seniors through work. I agree. Apart from money, seniors find friends,
meaning and purpose at their workplace. These are essential ingredients of
happiness.
6 Finding employment for those who are willing and able to work,
especially the lower-educated, is vital. Mr Sam Tan has spoken about the
CDAC’s Silver Talent Programme. I hope to see similar initiatives being
launched this year. This morning, I read that three job-related co-operatives
are being set up, two by our CDCs.

7 As important as having enough money, is having good health. In


recent years, the concept of a “rectangular” life has emerged. The Okinawans
prefer the balloon analogy, but let us stick to the rectangular life concept. In
the ideal world, we live a long and healthy life, followed by a swift and
peaceful end. One of my colleagues joked that a way to achieve a
“rectangular” life is to live unhealthily - eat char kway teow everyday, smoke,
drink, do not exercise - so that we can die quickly.

8 This seems an appealing thought. But it does not always work out this
way. Thanks to good healthcare, many of us can survive a stroke, heart
attack or cancer. Instead of having a “rectangular” life, we may face a
“triangular” life. The good news is that, everywhere in the developed world,
the number of years that a senior spends in illness and disability is falling.
This is called a “compression of morbidity”. Good sanitation, modern
medicine and healthy lifestyles are the identified key reasons. We will do
more to promote a healthy lifestyle in Singapore.

9 Science tells us that regular exercise is vital not only for physical health
and to reduce the risks of chronic illnesses, but even mental health. Many
popular exercises involve social bonding. Yet, three in four Singaporeans,
including seniors - or maybe especially seniors - are not exercising regularly.

10 The Straits Times recently reported about Mr Kor Hong Fatt, who
completed his ninth marathon at the age of 76. Remarkably, he only started
running at 70, after a heart attack. If we have not started early to exercise, it
is better late than never. It will improve the quality of life.

11 This year, Mr Heng Chee How will chair a committee to promote


physical activity for seniors. This is a public-people-private sector initiative to
make recommendations, promote and set targets on physical activity for our
seniors. The committee will also look at ways to enhance the physical
environment, so that seniors are motivated to exercise.

12 The Ministry of Health’s plans to introduce nationwide health screening


and nurse educators will also empower seniors to look after their health.
Listening to Members who spoke just now about whether we have adequate
support services for seniors, if we look at what has been announced by the
various Ministries, including the Ministry of Health, in the COS debate, there
are indeed elements that are being put in place. This way, we can look
forward not only to a happy life, but also a healthy and long one.
13 We also need to ensure that healthcare and long-term care are
accessible and affordable when they are needed. Improvements to
healthcare financing have been progressively introduced. MediShield has
been modified to return it to its original purpose, covering the insured for
higher hospital bills. Means-testing will be introduced so that more help can
be given to the lower-income.

14 As a proportion of the elderly population will need varying degrees of


long-term care, I led a team last year to study the comprehensive Japanese
long term care insurance system. We came back strongly convinced that we
cannot go down the same path. And Mr Khaw Boon Wan mentioned that the
demand was not according to plan and the claims simply ballooned. So, five
or six years after they have introduced it, I think there is a sense of crisis of
that system.

15 Families have been, and should continue to be, the first line of support
for the elderly. This is what most seniors want. This is what we will probably
want for ourselves when we grow old. Family ties are still strong in
Singapore. Although adult children are less likely to stay with their parents
compared to 10 years ago, it is encouraging that the frequency and level of
interaction are still strong.

16 Instead of a comprehensive insurance system that pays for care for the
elderly by for-profit private sector operators in nursing homes, we should
study how we can improve our ElderShield plan to support the family to take
care of the old. The Ministry of Health has indeed enhanced ElderShield
payouts, in the event of severe disability, and is 60% higher now, with a slight
increase in premiums. The principles underlying ElderShield are sound:
pooling of risks, self-reliance and choice by the individual and family on the
type of care, preferably at home.

17 Dr Lam Pin Min and Mr Christopher de Souza asked for the


Government to provide a caregiver allowance. As our population ages and
family size becomes smaller, the burden of caregiving will indeed increase.
Caregivers contribute to society by caring for our elderly. But putting a price
tag on what is traditionally a family duty should be considered very carefully.
It monetises obligations and responsibilities within the family. Both Members
have spoken eloquently for caregiver allowance. What is the solution? Or
should we say, “What are the solutions?” We are studying the matter,
including whether there could be further improvements to ElderShield. So,
sorry, this year, despite your pleas, there will be no caregiver allowance yet.
But we are looking at what we could do for the future.

18 We are also developing a caregiving support framework that includes


community-based care and home care. This means that family as first line of
care and support is not a mere slogan - we will help it remain a reality.

19 I will speak next about our efforts to promote ageing-in-place. The


elderly prefer to live in their own homes, within the community. They want to
be independent, not institutionalised. They want to be live among friends and
family. We have upgraded the environment to enable them to do so. All our
public housing estates are on target to achieve Barrier-Free Accessibility by
2011. All new HDB housing will have Universal Design features, friendly to all
ages. Forty percent of the bus fleet will be wheelchair-accessible by 2010.

20 Starting this year, all developments will also have to comply with the
enhanced Code on Accessibility in the Built Environment. It will cover
facilities such as parks, open spaces, transport stations and bus shelters.
Connectivity between buildings and with these facilities will be improved.

21 Over the last few years, the HDB has also built studio apartments for
seniors who want to monetise their property but still stay within the
community. The HDB has made it even easier for lower-income seniors to
age-in-place, by introducing the Lease Buy-Back Scheme.

22 We will also encourage families to stay near each other. HDB already
provides a higher-tier CPF Housing Grant to a first-timer family buying a
resale flat, if the family opts to live in the same flat or close to their parents.
The HDB will introduce a similar incentive to singles who buy a resale flat and
live with their parents. Eligible singles will now get an additional $9,000, or a
total of $20,000, if they choose to buy a resale flat to live together with their
parents.

23 We will also improve the software to support ageing-in-place. Together


with the Ministry of Health, MCYS is looking to enhance the quality and
integration of care in the community and home. Therapists will be engaged to
introduce "maintenance exercises" at daycare centres. To make it easier for
low-income seniors to visit these centres, a means-tested transport subsidy
will be introduced this year.

24 MCYS has also recently launched a Silver Community Test-bed


Programme to encourage companies to develop products that help seniors
age-in-place. Themes being pursued include home monitoring and enhancing
home safety. The physical and even service aspects of ageing-in-place are
relatively easy to achieve. The social aspects, including community self-help,
are harder to achieve. I will take these matters under Active Ageing.

25 Apart from good health, sufficient money and a familiar roof over their
heads, happiness also requires our seniors to connect, care and contribute to
others. The most natural setting is within the community. Mdm Cynthia Phua
and Mr Wee Siew Kim referred to it. What matters is not how many people
you know, but the quality of relationships that are formed. This requires
people to meet together regularly, more so in small groups than at large
events. Physical facilities may not be the solution. The software for getting
people to come together is far more important. Mr Wee Siew Kim might want
to know there is a Senior’s Lounge in Ang Mo Kio Hub, his constituency. But
the problem of bringing people to that centre is not the centre itself, but the
programmes and the software of bringing people there. Likewise, for Mdm
Cynthia Phua, neighbourhood links have been useful. However, we take a
pause to evaluate its effectiveness as compared to other programmes. And
there is, as far as I am aware, a daycare centre in her area in Lorong Ah Soo
run by St Luke’s. So it is not for lack of physical facilities that the old seem to
be left on their own. It is how the community is organised.

26 For the single elderly without family support, social bonds become
even more important. Neighbours and friends can look out for each other,
and help one achieve a good life. We are familiar with the Chinese saying,
"yan chin bu ru gin ling".

27 Mr Sam Tan's call is for the celebration of life. To achieve it, we need a
vibrant and connected neighbourhood.

28 The one million dollar question then is how do we promote social


bonds in the community? Mr Heng Chee How asks: in our changing social
environment, how does our grassroots morph to meet the current and future
needs of the people? Mr Wee Siew Kim asks for activity centres for the
elderly in convenient locations. Notwithstanding my remarks that the physical
facilities may not be the answer, PA is studying both the physical
infrastructure, such as community clubs of the future, and the organisational
support for grassroots organisations. So these will take sometime before we
come up with concrete plans.

29 Our grassroots organisations, especially the RCs, can and should play
a key role in promoting social bonds. PA has embarked on a recruitment
campaign for volunteers, targeting the better educated. This year, the
People's Association has decided to focus on "Neighbourliness". Over the
next year, the PA will work with the RCs to establish a register of interest
groups within their vicinity, not just those formed by the RCs, but also other
casual groups. This register will enable the RCs to support these groups and
organise platforms for different groups to get together. Collectively, they
widen the resident's social networks.

30 I would like to share three examples of social bonding in action. In


Choa Chu Kang, Mr Ravindran Kathergamathamby, a PA staff, started out by
organising parties involving families living on his floor. This year, he decided
to organise a bigger get-together for Chinese New Year cum the children's
birthday. Some 120 neighbours from eight floors and even their relatives
attended the event. They are now organising outings and overseas trips. By
tutoring each other's children, they save on tuition fees.

31 In Sembawang, Dr Lim Wee Kiak challenged his grassroots


organisations to host a 100 floor parties in order to reach out to his residents.
As an incentive, the residents get to take a group photograph with Dr Lim. To
date, a total of 55 floors from 30 different blocks have been covered by the
five RCs in Canberra. These floor parties help neighbours foster a "kampung
spirit". I understand Dr Lim Wee Kiak is hoping that this initiative will lead to
people organising floor parties on their own, and not waiting for the RC to do
so. This is how we foster a community spirit.
32 Seletar Hills is a private landed housing estate. In late 2006, Mrs
Chew Swee Liang, a grassroots leader, convinced 38 households to turn their
pavements into a mini-garden. She had support from the authorities. From
one street, three more streets have been added. 150 households are now
involved. From swapping gardening tips, they have gone on to having
breakfast and potluck parties. So another community that is reviving the old
kampung spirit.

33 HDB residents know on average 10 neighbours, according to a survey.


However, most of these are "Hello-Good Bye" relationships. Interest groups
and parties provide the platforms for neighbours to know each other. When
bonds strengthen, they will provide each other with mutual support, so
essential for the care of the elderly.

34 Like Mr Sam Tan, we are all saddened to hear about the Wong family
in Lorong Ah Soo, where the mother has dementia. Perhaps, a closer knit
community of neighbors can help reduce such incidents in future. We will
train the grassroots volunteers to enable them to identify those who need
help. There is a programme called the Community Psychogeriatric
Programme - a bit mouthful - which was launched last year, but VWO
members and hopefully our grassroots leaders will also be trained to identify
this kind of problems within the community. Social services, including the
Elder Protection Team under Transcentre, a VWO, also play an important role
in providing assistance.

35 Another VWO, the Alzheimer's Disease Association, will pilot an


initiative to identify seniors with dementia, if they lose their way or are found
wandering. Called "Safe-Return", these seniors will be issued an identification
card, which contains the contact information of their next-of-kin.

36 To answer Mr Ong Ah Heng, the Seniors Helpline (1800-555-5555),


managed by SAGE Counselling Centre, provides counselling and information
and referral services for older persons and their caregivers. Very often, we
say that people do not know where to go for help. Earlier, Mrs Yu-Foo Yee
Shoon gave one call number; here is another one.

37 Dr Lily Neo and Mr Wee Siew Kim spoke on legislation to protect the
elderly. We believe that existing legislation is sufficient for now. The
Women's Charter and Penal Code protect the elderly against physical and
emotional abuse. The Maintenance of Parents Act protects against financial
neglect. The Mental Capacity Act, when passed in Parliament, makes ill
treatment and wilful neglect of people with mental incapacity a criminal
offence.

38 Real protection comes from preventing these cases from taking place,
and if they do happen, to resolve them through mediation and counselling.
Applying the law should be the last resort. It makes reconciliation almost
impossible. Social workers find that many family disputes can be resolved.
Frequently, the issues revolve around ignorance about care giving and
relationship issues, financial hardships, and even neglect or unbecoming
behaviour by the parents. There is only a small minority of 'unfilial children',
which should be swiftly dealt with by the law.
39 We will continue to make efforts to raise public awareness of elder
abuse and maintenance of parents. But as importantly, we must strengthen
the help offered to the elderly, to reconcile with their family, where possible.
Very often, the one complained about is also the one providing the financial
support. So we have to be very careful to treat this sensitively and delicately
so as not to break that relationship forever.

40 But neighbours can play a part too, to help watch out for elderly
neighbours and support those with care giving responsibilities, and this is why
strong social bonds in the community are important.

41 Whilst the community can facilitate and support, the individual must
also do their part to be active. Our seniors lead very sedentary lives.
Hitherto, society's image of the elderly is that of frail men and women using
walking aids or wheelchairs. Typically, whenever we want a picture to depict
the old, that is what comes up. This is not true of our seniors above 75 - eight
out of 10 of them do not need walking aids to get around. The emerging
generation of seniors - post-war baby boomers - are even better educated,
healthier and probably wealthier. So we have to change the conventional
image of the elderly.

42 Mr Baey Yam Keng asked what we are doing to promote an active


lifestyle for seniors. Last May, the Council for Third Age was established to
champion active ageing. MCYS currently funds the Council. On the Ministry's
behalf, the Council also administers public education and the Golden
Opportunities (GO!) Fund.

43 One of the first things the Council did was to re-brand Senior Citizens'
Week to the Active Ageing Festival, which was held last November. The
Festival had a good start. This year, the Council intends to promote active
ageing more extensively. It will work with the CDCs to bring this message to
the community.

44 Over the next two years, a Wellness Programme will be piloted in six
sites all over the island. Two have been launched at Jurong Central and
Punggol South. The key objective of the Wellness Programme is to support
seniors in the community by identifying and meeting their needs, through
information and referral, service coordination and development, as well as
outreach efforts to promote active ageing and wellness. Each site is expected
to reach out to at least 1,000 seniors. MCYS is allocating $4 million to this
pilot. One element of this is to help the seniors improve the quality of their
life. Health screening is one part of the programme, but to get them, from the
results, to a healthier lifestyle is the difficult part. KPIs will be established to
see whether this Wellness Programme really makes a difference.

45 Although each Wellness Programme will have at least two full-time


staff, the support of the Advisor, grassroots leaders, Government agencies
and the community-at-large is crucial to ensure it meets these objectives. The
objectives of the Wellness Programme are very much in line with the
fundamental objectives of grassroots organisations - bonding the community.
So this Wellness Programme is not something we do separately; it is
something we will have to do together with the grassroots organisations within
the constituency.

46 For now, the Wellness Programme is a pilot. Each site is given the
leeway to experiment with what works best for their community. As
mentioned, outcome indicators will be monitored to closely track for
effectiveness. After two years, the Government will evaluate how the
Wellness Programme can be rolled out nationwide. Whilst a number of
Members are very anxious that they have a similar programme within their
own constituency, I think it is best for us to see what the pilot comes up with,
what works and what we can do to bring the best practices together to make it
a successful programme.

47 So far, I have shared what the Government, in partnership with the


people sector, is doing to help seniors achieve a happy, healthy and active
life. But there is no reason why the private sector cannot be involved. The
private sector can service the needs of our ageing population, while being
profitable at the same time. The Health Ministry's pilot scheme to open up
subsidised nursing home beds to the private sector is an interesting
experiment.

48 Two months ago, the Silver Industry Committee, under Mr Philip Yeo,
successfully organised a silver industry conference and exhibition. The public
response has been very encouraging. I understand that exhibitors are keen
to participate next year.

49 Scaling up for the silver business is increasingly possible. It is not just


Singapore which is rapidly ageing, but also the rest of Asia. By 2050, 1.2
billion people will be above 60 years old, four times the number today. This
is as large as China's population today!

50 This year, the EDB has made health and wellness a key growth theme.
It intends to work with partners, such as healthcare providers, to create
development platforms, such as "Hospital of the Future" and Home and
Community Care. These platforms allow companies to develop products and
services for an ageing population.

51 Last year, I shared that the Ministerial Committee on Ageing would


pursue four strategic thrusts: Financial Security, Healthcare, Ageing-in-Place
and Active Ageing. We are making progress in all these areas. These thrusts
all lead to one vision of successful ageing - happy, healthy and active seniors.
The Government cannot do this alone. The family and community provide the
social bonds and care that make life worth living. The individual must be
committed to a long and happy life.

52 At 110 years old, Sister Teresa Hsu is probably the oldest active ager
in Singapore. She has been serving the community most of her life. I would
like to share a quote on her philosophy of life: "I prefer to laugh than to weep.
Those people who cry to me, I always tell them it is better to laugh than to use
tissue paper. Laughing is free but tissue paper still costs five cents."

53 Teresa Hsu is committed to a long and happy life, and may all
Singaporeans emulate her.