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     Preparing for an ageing population

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MINISTERIAL COMMITTEE ON AGEING:

REPORT FOR 2007

 

Background

 

Singapore has one of the world’s fastest ageing populations. By 2030, one in five residents will be 65 and above, from one in 12 today. By 2050, Singapore is projected to be the fourth oldest country in the world[1]. Population ageing undeniably brings challenges. But it also provides us opportunities to transform our socio-economic infrastructure to help Singaporeans enjoy healthy and happy lives in their golden years.

 

As a country, Singapore is well-positioned to take a coordinated and proactive approach to deal with this demographic shift.  In Mar 07, the Government established a Ministerial Committee on Ageing chaired by Minister in the Prime Minister’s Office, Mr Lim Boon Heng.  The composition of the Committee can be found at Annex A.  With the vision of achieving “Successful Ageing for Singapore”, the MCA is committed to pursuing a whole-of-government response to ageing along the following strategic thrusts:

 

 

·                    Enhance Employability and Financial Security;

·                    Provide Holistic and Affordable Healthcare and Eldercare;

·                    Enable Ageing-in-Place; and

·                    Promote Active Ageing.

 

Overview of the Year’s Policies and Initiatives

 

Good progress has been made in the four identified strategic thrusts and will be pursued in 2008. Recommendations of the earlier Committee on Ageing Issues are being implemented and will be subsumed under the agenda of the Ministerial Committee on Ageing.  The summary of these recommendations and their implementation can be found at Annex B[2]. The high priority given to population ageing in the government’s agenda was also reflected in speeches and measures announced throughout the year, including PM Lee Hsien Loong’s National Day Rally speech on 20 Aug 07.

 

The Government’s efforts to prepare Singapore for an ageing population must involve the community.  Individual Singaporeans and their families should be empowered to take responsibility for their social, health and financial needs.  A pilot Wellness Programme, announced in Sep 07, seeks to provide older Singaporeans with information and opportunities to lead healthy lifestyles and remain socially engaged within the community.  The pilot programme will be implemented progressively at six sites in Singapore over 2008.

 

There is potential for the private sector to expand its role in an ageing population to meet different needs of different population segments.  In the nursing home market, MOH will look to facilitate the entry of providers which can add value to this sector and introduce measures to encourage market competition.  In a rapidly ageing Asia, a “silver industry” in Singapore can also contribute to our economy.  The Silver Industry Conference and Exhibition (SICEX) on 10-13 Jan 08 profiles the new lifestyle and business opportunities in providing products and services for baby boomers[3].

 

 

Progress under the Strategic Thrusts

 

Enhance Employability and Financial Security

Having sufficient retirement savings at old age is fundamental to successful ageing in Singapore.  Measures were announced along the following thrusts – helping Singaporeans work longer; improving returns on CPF savings; and making savings last for the lifetime of CPF members.
 

Helping Singaporeans Work Longer

The employment rate of older residents aged 55 to 64 rose by 2.5% points over the year to 56.2% in Jun 07[4], as a result of a buoyant economy and initiatives implemented.  In May 07, the Tripartite Committee on Employability of Older Workers released its final report with an extensive package of recommendations, including the introduction of legislative changes within five years to facilitate opportunities for older workers to continue working beyond the age of 62[5].  More will be done to positively shape the mindsets of employers and employees towards employing older workers and to facilitate the re-design of jobs to make them more suited for older workers. 

One significant policy announced at Budget 2007 was the Workfare Income Supplement (WIS) Scheme for older low-wage workers.  Although CPF contribution rates for older, low-wage workers have been reduced to enhance their employability and give them more take-home pay, the Government will give them WIS from 1 Jan 08, which will more than make up for the reduction in their CPF and help build up their retirement savings.

Improving Returns on CPF Savings

From 1 Jan 08, all CPF members will earn an extra 1% interest on the first $60,000 in their CPF accounts including up to $20,000 from the Ordinary Account (OA). The interest rate for the Special, Medisave and Retirement Accounts (SMRA) will also be pegged to the yield of the 10-year Singapore Government Securities (SGS) plus 1% so as to better reflect the long term nature of these funds. 

Making Savings Last for CPF members’ Life Expectancy

Because Singaporeans are living longer, their retirement savings also need to last longer.  The Minimum Sum Draw-Down Age will be progressively raised from the current 62 to 65 by 2018.  A Deferment Bonus (D Bonus) will be given to CPF members who are most immediately affected by the changes in draw-down age.  Older CPF members who volunteer to defer the draw-down of their CPF savings to the age of 65 will also receive a Voluntary Deferment Bonus (V Bonus).

The Government is considering a longevity insurance scheme which will give CPF members a basic income for as long as they live. A committee chaired by Professor Lim Pin is studying the design of a scheme that will provide basic, affordable and flexible plans to ensure long-life income for CPF members.

PM Lee also announced HDB’s Lease Buyback Scheme during his National Day Rally speech on 20 Aug 07.  This is a subsidised scheme targeted at elderly households living in 2-room and 3-room HDB flats and offers another option for the elderly to monetise their flats.  Under the scheme, HDB will buy back the tail end of the lease, leaving the flat owner with a flat that has a 30-year lease remaining.  The cash that is released, including the subsidy provided by Government, will be given progressively to the flat owner to supplement his retirement income.
 

Provide Holistic, Affordable Healthcare and Eldercare

An ageing population with higher life expectancy is associated with higher prevalence of chronic and other medical conditions[6].

A holistic approach towards caring for the elderly must cover their physical, emotional and mental needs.  More focus should also be given to prevent and better manage diseases, before more expensive institution-based treatment becomes necessary.  Older Singaporeans, supported by caregivers and the community, should also be empowered to take care of their own health and wellbeing[7].

Family physicians, with their close proximity to the community, can help ensure that patients receive the most appropriate level of healthcare services within the community.  MOH’s Chronic Disease Management Programme (CDMP) empowers family physicians to adopt a holistic approach in managing the healthcare needs of their patients[8].  Other chronic diseases are being studied to see if they would fit into this programme.
 

Affordability and Integration of Eldercare

The ElderShield Scheme was recently enhanced in Sep 2007 to help raise the affordability of step-down care services.  The new basic ElderShield, which pays $400 per month in cash for up to 6 years, in the event of severe disability, is a significant 60 per cent improvement from the previous scheme, which pays out $300 per month for 5 years. 

MCYS and MOH are also conducting a review of eldercare services.  This is aimed at integrating and enhancing the effectiveness of existing services to better serve the needs of the elderly.  Key services and programmes being reviewed include the possible streamlining of daycare centres and day rehabilitation centres, befrienders and home help services to better enable ageing-in-place.  We would also examine the roles played by Seniors Activity Centres and Neighbourhood Links.


 Support for End-of-life Care and Concerns

There is a need to improve end-of-life care, especially for patients and their caregivers during the last phase of the patients’ lives.  MOH is currently studying aspects of end-of-life care such as patient preferences on the place of death, as well as making it easier for Singaporeans to sign an Advanced Medical Directive (AMD).  In addition, MOH will increase its support for hospice and palliative care services for those patients with terminal illnesses, by strengthening the healthcare workforce, enhancing career prospects and planning for the long term manpower needs of the sector.

MCYS has completed public consultation on the Mental Capacity Bill which would enable individuals to appoint proxy decision makers in advance should they lose their mental capacity due to illnesses such as dementia.  MCYS will introduce the Bill in Parliament in 2008.

Enable Ageing-in-Place

Ageing in one’s home and within the community is beneficial to older people’s wellbeing.  To enable ageing-in-place, it is vital that the living environment and public transport system is accessible and barrier-free to older people.

To this end, the Government developed a Barrier-Free Accessibility (BFA) Masterplan in 2006.  Among the milestones achieved under the Masterplan in 2007 is the revision and renaming of the BFA Code to “Code on Accessibility in the Built Environment”[9].  While the Code will come into effect on 1 Apr 08, some of these new requirements have already been imposed administratively.

Going beyond the requirements of the Code, BCA is promoting Universal Design (UD) principles to the industry through courses, seminars and training.  As part of this effort, BCA has launched a comprehensive UD guide to provide the industry with a set of recommended design guidelines applicable to residential units and communal facilities like parks, stadiums and cinemas. 

With regard to public housing, HDB is working closely with the Town Councils (TCs) to ensure that BFA in all HDB estates will be achieved by 2011[10].

HDB’s ongoing Lift Upgrading Programme is progressing well, and we are on target to have full lift access for all eligible HDB blocks by 2014. HDB has also introduced UD features in all new public housing projects tendered from July 2006.  MCYS is also introducing ways to support active ageing and ageing-in-place in the community, including the pilot Wellness Programme.

As for public transport, most MRT stations have been retrofitted since 2006 and are barrier-free today.  The first wheelchair accessible buses were introduced in 2006.  By 2010, 40 per cent of the public bus fleet will be wheelchair-accessible.

 

Promote Active Ageing

The benefits of older Singaporeans leading healthy and happy lives accrue at the level of the individual, community and nation.  Research has shown that leading active and purposeful lives, i.e. active ageing, can improve an individual’s wellbeing and even reduce the risk of the onset of chronic diseases.  In turn, it enables older Singaporeans to continue to contribute to society.

In May 07, the Council for Third Age (C3A) was established to champion active ageing.  The C3A will administer on behalf of MCYS the $20 million Golden Opportunities (GO!) Fund to promote community-based projects related to active ageing.  To give sharper focus to the message of active ageing, the Council re-branded the Senior Citizens’ Week to Active Ageing Festival, which was held in Nov 07.

Dialogue sessions with the social service sector, community groups and individuals in Jul 07[11] showed that apart from bread and butter issues, participants also expressed the need to strengthen intergenerational bonds and promote lifelong learning.  The Government will explore ways to do this, in collaboration with the private and people sectors under the “Many Helping Hands” approach.
 

Date                      :         15 Jan 08

[1] UN Population Division’s “World Population Prospects: The 2006 Revision”. The median age of Singapore's population is projected to be 54 years by 2050, behind Macau (56), Japan (55) and Korea (55).

[2] The Committee of Ageing Issues issued its report and recommendations in February 2006.  Co-chairing the committee were Senior Minister of State for Information, Communications and the Arts, Dr Balaji Sadasivan, and Parliamentary Secretary for Community Development, Youth and Sports, Dr Mohamad Maliki Osman.

[3] The Silver Industry Conference and Exhibition is organized by the Silver Industry Committee, which was established in November 2006 to explore and develop the silver industry in Singapore.  Reporting to the Ministerial Committee on Ageing, the committee is chaired by Mr Philip Yeo, Chairman of SPRING Singapore, and has members from the private and public sector. 

[4] The Government’s long-term target is an employment rate of 65% for this cohort of residents.

[5] Other recommendations include enhancing WDA's ADVANTAGE! Scheme; expanding the employment opportunities of older women and enhancing their employability; a higher Workfare Income Supplement payout to low income workers above the age of 55; expanding the promotion of fair employment practices through a Tripartite Centre for Fair Employment and instituting an award to recognise companies for implementing fair employment practices.  See http://www.mom.gov.sg/publish/momportal/  for the report.

[6] In 2004, prevalence of diabetes mellitus was 16.7% for those in the 50-59 age group, and 28.7% for those in the 60-67 age group; for hypertension, the prevalence was 36.2% in the 50-59 age group, and 56.1% in the 60-69 age group. Source: National Health Survey, 2004.

[7] Examples include a Caregiver Training Grant in 2007 to subsidise the training for families to care for their seniors with disabilities, as well as development of an Elderly Health Promotion Blueprint by the Health Promotion Board to provide evidence-based strategies for health promotion, disease and related risks, and disability prevention for adults aged 65 and above.  The Blueprint will be implemented in FY2008.

[8] As of November 2007, 85,000 patients have used their Medisave under the CDMP with a total draw-down on Medisave of about $15 million for 2007.

[9] The revised Code will cover beyond buildings to other facilities such as parks, open spaces, transport stations and bus shelters.  Interconnectivity will be improved between buildings, and from buildings to nearby facilities such as transport nodes and parks.  The revised Code also requires at least one bathroom in each new residential unit to have enough space for retrofitting with elder-friendly features when the need arises.

[10] These features include minimising level differences within the flat (e.g. at entrance, bathroom and service yard), ensuring doorways and internal corridors are wide enough for wheelchair access, and providing at least one wheelchair accessible bathroom.  There will also be provisions for residents to add on other elder-friendly features when the need arises, e.g. grab bars in the bathrooms.

[11] Co-organised by the Council for Third Age and REACH.

Source: www.mcys.gov.sg Media Release 15 Jan 2008