Let's Bring Down Workplace Ill-health

20 Nov 2008

By Khaw Boon Wan

Mr Lucas Chow, Chairman, Health Promotion Board

Distinguished Guests

Ladies and Gentlemen

1 This is the 5th HEALTH Award presentation ceremony that I have attended.   It is a good occasion to review our progress in workplace health promotion and to set new goals.

Why Workplace?

2 Our objective is to promote healthy lifestyles among all employees.  Three out of four adult Singaporeans are in the workforce.  This is a huge captive population.  Workplace is a logical place to roll out health screening, health promotion activities and chronic disease management.  If we can persuade all employees to adopt a healthy lifestyle, we will have made a huge inroad into our strategy to get all Singaporeans to do the same.

3 We have made some progress.  10 years ago, only one-third of our companies had a structured workplace health promotion programme.  Their workers made up a quarter of the working population in Singapore.   Today, three in five companies do and their workers account for three-quarters of all workers in Singapore. A clear majority of companies and employees are now on the healthy side of the divide.  This is a great achievement.  These companies provide the base from which HEALTH award winners are identified.  We will shortly give out HEALTH awards to 358 companies.  This is triple the number 10 years ago.

Look for gold and platinum

4 From the HEALTH award recipients, we picked the Gold and Platinum Award winners to acknowledge and profile those companies which have gone the extra mile to get their employees to embrace a healthy lifestyle.  This year, there will be 120 Gold and 41 Platinum winners. 

5 It is not easy to win the Platinum Award. As a Platinum winner, my Ministry knows this from first-hand experience. It requires strong and sustained support from officers at all levels, to develop workplace health policies, market them, and energize the staff to participate regularly in the health activities. As you know, it is not easy to get people to exercise once they settle into a comfortable position and given their busy workloads. We need both incentives and some peer pressure! We provide subsidies and protected time for healthy lifestyle programmes. In MOH, every Friday is Sports and Social Day when staff are given up to 90 minutes off from work in the evening to take part in organised sports activities. We find the investment worthwhile as these activities also build up teamwork and camaraderie among staff. Beyond physical activity programmes, we also focus on healthy eating and mental well-being. Every fortnight, we have lunch-time fruit bazaars, and educational talks and workshops on mental well-being. Every other years, we carry out health screening and fitness assessments for our staff.

6 As you can see, workplace health promotion is a full-time commitment.  It is about changing work culture and environment. It is a movement which requires a strong committed leadership, a responsive workforce and a supportive healthy lifestyle culture.  To reinforce the culture, there must be demonstrable results through real improvements in the employees’ health status, reduction in healthcare cost and employee turnover.  Both employers and employees must experience tangible results from their efforts, or the movement will not last.

Let’s shift gear

7 Ten years of workplace health promotion has built the foundation for us to now aim higher and strive for larger goals.  I want to use this occasion to signal this shift in gear and rally all employers and employees to support this shift and join this movement.

8 Why do we need to make this shift?  Firstly, the health burden of chronic diseases such as diabetes, high blood pressure and lipid disorder is growing and we need to bring it down.  To do so, we need to manage chronic diseases more systematically and more effectively than in the past. Probably half of Singaporeans with a chronic disease are still ignorant of their condition.  Among those who are aware and on treatment, probably half are not taking their medication and changing their lifestyles as prescribed.  These failures are costly to the patients and their families.  The chronic disease will not go away, it will get worse, resulting in nasty complications requiring expensive hospitalisation and major treatment.  We must correct these failures and prevent these unnecessary complications.

9 Second, our population is ageing. Currently, our workforce is still relatively young, but in 10, 20 years’ time, there will be a significant impact of ageing in terms of higher morbidity. It is starting to show: hospital A&E loads, admissions and outpatient workloads are all increasing rapidly, faster than the previous decade, as our baby boomers, like me, turn elderly. From now on, the increases in demand will far exceed the growth rate of our population.  We are expanding hospital capacity to cope with the expected increase.  But it is far more effective to try to reduce demand by preventing ill-health.

10 Thirdly, we are extending retirement and promoting re-employment of older  workers. There are many obstacles to re-employing older workers, including attitudes, age discrimination and so forth. But a major factor is the health of the worker.  No employer is keen to re-employ a sickly employee.  New skills and continuing retraining will help make elderly workers more employable, but their health is a crucial factor too.  Part of making ourselves employable is to make sure we are fit and healthy.  Our union leaders must get this important message to their members.  Needless to say, they must lead by personal example and be role models for a healthy lifestyle, with healthy eating habits, regular exercise, and waistline within the healthy range.  If they are smokers, then they should quit smoking immediately.  They should go for regular screening, and if they have chronic diseases, take their medication as prescribed by their doctor.

11 Fourthly, healthcare costs will continue to rise and workplace ill-health will become more costly.  For employers, supporting workplace health is a no-brainer. Lost productivity and absenteeism, not to mention the cost of providing employee medical benefits, all hurt the company bottom-line.  In the US, General Motors spends twice as much on employees’ medical benefits as they spend on steel, a key raw material for their cars.  

Fighting a common enemy

12 For these reasons, all tripartite partners share a common interest to bring down ill health at workplace. We have a common enemy.  Promoting health is not the sole responsibility of MOH, but extends way beyond MOH and the Government to practically every other organisation.  It is our joint responsibility as a nation.  That is why our Prime Minister tries to make it a point to launch the National Healthy Lifestyle Campaign every year, as he did recently.  

13 It is especially important to promote workplace health because most Singaporeans spend a considerable amount of time in the workplace.  The workplace is a captive setting to promote health messages and lifestyle changes. It is an efficient setting to conduct mass health screening in the most cost-effective way.  It is a conducive setting to leverage on peer support to get employees with chronic diseases to comply with their medication and to make the necessary lifestyle changes. 

14 No employee wants to fall sick.  No employer wants his employees to be sick.  No colleague likes to be burdened whenever his other colleagues report sick. All insurers hope that nobody falls sick.  We are all on the same side of the battlefield.  We are natural partners in this fight against workplace ill-health. 

Tripartite support

15 I discussed this strategic shift with NTUC Sec Gen Minister Lim Swee Say, Deputy Sec-Gen Halimah and Mr Yeo Guat Kwang.  They readily lent their personal support to this cause and offered the full backing of the NTUC.  I discussed this with the President of the Singapore National Employers’ Federation (SNEF) Mr Stephen Lee and his Executive Director Mr Koh Juan Kiat.  They too gave me their personal support.  I discussed this with a few Platinum Award Winners and other business leaders.  They were all enthusiastic and offered to help drive this movement.  Together, I believe we can move the Workplace Health Promotion Programme to the next level. 

16 Let’s bring down ill health at workplace.  This will require the development of a multi-year strategy to make every workplace a healthy workplace and every employee a healthy employee.  There are many things we can do.  Let’s get all employees to be screened regularly.  Let’s pick up all employees with a chronic disease and persuade them to comply with medication and lifestyle changes.  Let’s get the smokers to quit smoking.  Let’s organize lunch time talks and demonstrations by professionals.  Let’s measure waistlines like what the Japanese workers regularly do, and persuade the overweight to reduce their waistlines.  Let’s review canteen and cafeteria menus, remove junk food and offer healthier choices.  Let’s run first-aid courses and CPR training so that employees can attend to simple emergencies. Let’s measure and compare employees’ sickness rates.  Let’s persuade insurers to reward companies with good healthy records by providing premium discounts for their group insurance plans.  Let’s study how others organize their programmes and learn from one another.

We have excellent role models

17 The SAF offers useful lessons for us.  They believe that health promotion is a key pillar to fulfilling its mission of protecting the country.   Four key strategies drive its Motto of “Healthy Forces, Healthy Nation”.  One, education and know-how to achieve physical, mental and emotional wellness. Two, promotion of the benefits and fun of leading a healthy lifestyle. Three, incentivizing and recognizing the health efforts at both the individual and unit levels.  Four, surveillance by monitoring key health indicators and conducting health screening for early detection and treatment of chronic conditions. 

18 They have nutritionists to plan the dishes in their cookhouse.  All regulars undergo an annual BMI screening; those with unhealthy BMIs are referred to its Weight Management Programme. With chronic lifestyle-related diseases on the rise, the SAF has stepped up its efforts to ensure that high-risk individuals are actively followed up via a system of counseling, education, support and referral for continuation of care.  It has a comprehensive smoking cessation programme.

19 Can all employers adopt the SAF norm?  Very few companies have the unique advantages of the SAF environment.  But many Platinum winners have achieved almost similar levels of outcome, without the need for uniforms and exercise of authority.  IBM is an excellent example of such a company.

20 IBM treats workplace health programme as part of its broader emphasis on work-life integration that helps it attract talent.  For them, it is a staff retention strategy that also boosts productivity. They encourage staff to self-start interest groups; this has resulted in diverse staff-led activities, ranging from dragon boat to triathlons and marathons. They encourage employees to take personal responsibility for their health by making screening more convenient, for example, by bringing the “mammo-bus” right to the doorstep for breast cancer mammogram screening. IBM employees have access to confidential, professional counselling service for stress. With its relentless efforts and strong programme, IBM staff have become healthier over the years, and medical cost per employee has dropped by 14% between 2004 and 2007.

21 Jurong Shipyard is another role model with an excellent programme especially for its older employees.  Since year 2000, Jurong Shipyard has started promoting the importance of health screening and has put in place a Chronic Diseases Management Programme. As a result of effective promotion, employee participation in health screening has increased from 28% at the start of the programme to 68% last year.  Employees with risk factors are closely monitored by in-house company doctors and nurses, and encouraged to attend follow-up programmes such as diabetes care, weight management and smoking control.  Last year, Jurong Shipyard has tied up with Alexandra Hospital to launch a Chronic Disease Medical Plan to ease the financial burden on retired staff seeking treatment for chronic illnesses.  More than 200 retirees are expected to benefit from this scheme, which will subsidise them for 80% of treatment cost incurred over the next 5 years.  

22 Jurong Shipyard's efforts have yielded significant results.  They now have fewer employees with high cholesterol and high blood pressure.  Their average medical cost per employee has dropped by one-third between 2000 and 2007. 

Conclusion

23 Let’s get all employers to be like the SAF, IBM, Jurong Shipyard and many other Platinum winners.  Their way of managing employee health, fitness and weight should be the norm for all to follow.  With the support of employers and unions, I’m optimistic that together, we can shift our gears and move the Workplace Health Promotion Programme to its next level.  We can push the health agenda at workplace almost the same way the earlier leaders pushed for good industry relationship.  Please join me to fight the win against workplace ill health.  Let’s bring down ill health at workplace the same way we brought down industrial actions in the past.