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16 Aug 2010
Question No: 242
Question
Name of the Person: Assoc. Prof Paulin Tay Straughan
To ask the Minister for Health in view of the improvement in life expectancy for Singaporeans (a) what is the corresponding data on Disability-Adjusted Life Expectancy (DALE); (b) in terms of healthcare provisions, what plans does the Ministry have to prepare for a rapidly ageing society; and (c) what initiatives are there to manage chronic ailments and promote the take-up of preventive health screening among near-elderly and elderly Singaporeans.
Reply
Reply From MOH
Singaporeans are indeed living better and longer. Among 193 countries with published life expectancy at birth, we are ranked number 9 in the world, together with 7 other countries. This is a commendable achievement.
Correspondingly, our Disability-Adjusted Life Expectancy or DALE has also improved. DALE is a population health indicator based on life expectancy, with an adjustment for years lived in poor health due to illness or injury. It has since been renamed HALE for Healthy Life Expectancy.
HALE for Singaporeans at age 60 is now 17.0 years for men and 20.3 years for women. This suggests an expected loss in healthy years of 4.1 years for men and 4.6 years for women. This is better than the global figure of 4.3 years for men and 5.3 years for women. But we must continue to make improvements where we can.
How are we preparing for the ageing of our population is a subject that occupies the mind of many Ministers. We take a whole-of-Government approach to this important subject. Minister Lim Boon Heng chairs a Committee on Ageing, of which I am a member. We meet regularly to discuss and brainstorm this subject. Our strategy and our plans are regularly shared with the public and are often discussed in this House.
In the areas under my purview, half of my time is spent working out solutions to ensure that our seniors can age with grace and dignity, free of pain if medically possible. Part of my mission in life is “老者安之”: “help the seniors achieve peace of mind”. I cannot do this alone but do require Singaporeans to join me in maintaining a healthy lifestyle, saving regularly for a rainy day, subscribing to our insurance policies and accepting that we are mortals and there are limits to the medical science.
I have shared the specific initiatives frequently and widely. I do not propose to repeat them comprehensively this afternoon. Briefly they include 6 key elements.
First, ensure that capacity and capabilities match rising demand. This includes building new general hospitals, community hospitals and nursing homes, training and recruiting healthcare professionals including doctors, nurses, and allied health professionals.
Second, encourage Singaporeans to embrace a healthy lifestyle seriously. Make it a part of our life. It is not that difficult: do not smoke, do not over-eat, exercise regularly, socialize and make friends, avoid junk food.
Third, build up the home and day healthcare sector. Seniors do not want to visit hospitals, if they can help it. The risk of a hospital-acquired infection is real. Most treatment is routine and can be done by properly trained doctors, nurses and therapists in the community setting.
Among the various initiatives, we are helping to transform the Home Nursing Foundation to help push this effort.
Fourth, many Singaporeans will have some sort of a chronic illness, like diabetes or a heart disease like me. Go for regular screening so that you are aware of your illness and work with your doctors to manage it before it becomes critical and irreversible. In my case, the heart screening literally saved my life and avoided a fatal heart attack.
For many years, several MPs, including Dr Lily Neo and Mdm Halimah have supported community health screening among our seniors. We have built on these bottom-up efforts and grown them into a national programme.
The Health Promotion Board has branded this as the national Integrated Screening Programme (ISP) to encourage all Singaporeans above 40 to be screened regularly for diabetes, high blood pressure, high blood cholesterol and obesity. Many GPs have joined us in this effort.
Our surveys showed that more than 70% of Singaporeans above age 40 had gone for a recent health screening for diabetes and high blood cholesterol. This is encouraging and we will continue to push it. Health screening is not a once-off event, but must be done regularly.
ISP has now been extended to the workplaces, to the door-step of employees working in small and medium-sized enterprises (SMEs). We are making screening accessible but we need Singaporeans to join in.
Fifth, chronic disease has to be treated, either with medication and/or lifestyle change. This requires the patients to work closely with their GPs. Make sure you have a regular Family Physician who knows you well and whom you trust. Take his advice and comply with his prescription. Medisave can help pay part of the outpatient treatment and many patients have benefitted from this programme.
Finally, a senior patient will likely need to consult several healthcare professionals from the acute hospital, community hospital, home and day healthcare providers, GP clinics and, for some, the nursing homes. Services are fragmented with poor coordination. We are striving to transform the delivery model so that these diverse services can be better coordinated and integrated where possible. The strategic intent is to enable a frail elderly who tend to have multiple and more complex care needs, to receive care more seamlessly and in the appropriate settings. We have started the Agency for Integrated Care (AIC) to help facilitate this transformation. This is still work in progress. But already, their Aged Care Transition (ACTION) Teams based in the restructured hospitals are doing good work, facilitating discharge planning and coordinating referrals to intermediate and long-term care services to smoothen patient transitions between institutions.
We are expanding the AIC to coordinate and drive care integration efforts. We are transforming our acute hospitals into regional hospitals to bring together public, private and VWO providers across various healthcare settings and strengthen the linkages between them. They will need infrastructure support, including the upcoming National Electronic Health Records system.
We do not underestimate the huge challenges in this transformation of our healthcare services. It is literally a revolution, but a quiet one, making progress day by day, clinic by clinic, hospital by hospital. But if we succeed, Singaporeans will be better able to live well, live long and with peace of mind.