Outram Campus Social Workers' Day Celebrations

19 Jan 2007

By Ms Yong Ying-I, Permanent Secretary (Health)

Venue: SGH

First Time Celebration

Tomorrow marks Singapore's first Social Workers Day. This will be a landmark event for social workers in Singapore. We will celebrate your profession, and raise public awareness on social workers' contribution to society.

Today, I would like to pay special tribute to our Medical Social Workers, our "unsung heroes", who have been working effectively but quietly in the background of our healthcare institutions and social sectors. They help patients tackle their financial problems. They help patients with discharge needs to help ensure that they continue to get appropriate care after they leave the hospital. They help counsel patients and families to be better able to manage their health challenges. Medical social workers are vital members of the healthcare team.

Beginnings

I am told that the social work profession started in Singapore 58 years ago, and had its beginnings in hospitals. The first almoner, or social worker as they are known today, was Ms N. Tanburn, an English who started the Almoner Department in SGH in January 1949. In 1958, the first local almoner, Ms Vaithilingam, took over as head of the almoner service for hospitals under the Ministry of Health. In the early 70s, there were only 44 medical social workers for all the government hospitals. This is approximately the number of medical social workers we have today on Outram Campus alone, with 40,000 caseloads every year.

Medical Social Work Today

A good part of medical social work is focused on meeting the practical needs of patients, which may go beyond the purely clinical. With an aging population and as our urban society becomes more complex, I see an expanding role for medical social workers and I support an increase in their numbers across our healthcare system. Let me explain why.

Today, a big component of the caseload of our present MSWs is related to helping patients and their families resolve financial problems with hospital bills. They also spend time helping patients with issues like daily maintenance after they leave hospital and with the acquisition of medical appliances. This reduces their availability for psychosocial interventions. But if you look at what MSWs in advanced developed countries do, much of their work relates to discharge care and counseling. I see our going this route as well.

Let me give you an example. It is important that healthcare be delivered cost-effectively, and one of the key elements of cost-effective care is right-siting of medical care. Staying in tertiary hospitals like SGH is naturally more expensive than in step-down care institutions. Now, a patient may be ready for discharge from SGH, but may not exactly be ready to go home. This is especially so if families may not be able to provide the care and assistance that the frail patient needs for the next stage of his recovery. MSWs can play critical in organizing care-giving arrangements within the community. They can continue to check on the patient post-discharge. They can help advise and counsel the family, so that the family is better able to support the patient.

If we can expand numbers, we can do more. Ideally, the profession should be able to have sufficient resources to invest in teaching, training, research and specialization. This will help the profession build its standing and get greater recognition for the work that they do as their roles are better understood. If MSWs are able to intervene more actively and intensely, and play an expanded role in the healthcare team, it will help relieve the pressure on doctors and better enable them to focus on what they do best. One of the roles that MSWs may be best equipped to do amongst the healthcare team is community outreach to parties that all affect the patients' psychosocial needs arising from ill health. One of these is employers and workplaces. A doctor told me recently about his patient being very worried that he could not get the rest he needed to recover from his medical condition because he would lose his job and the pay-check that came with it. These are real issues that matter greatly to the patients' health but they are not clinical issues per se. These are the sorts of challenges that we will need innovative approaches to address.

The work of a medical social worker may be demanding, but it is precisely this that makes it fulfilling for those with a passion for the profession and a fundamental belief in improving the lives of those in need. As MSWs, you are in a unique position to see the broader picture of patients' needs vis-a-vis the community's. Your challenge is to identify and bring about the complex but effective solutions. I encourage you to go forward and wish you well. My Ministry will do our best to support you.

I congratulate SGH, as our flagship hospital and the seat of medical social service in Singapore, for providing the leadership for the development in medical social work services. On this note, I wish all social workers in hospitals and in the community, a Happy Social Workers' Day.