Speech by Dr Amy Khor, Senior Minister of State (Health), at the Voices for Hospices 2013 Charity Concert, on 12 Oct 2013

Dr Akhileswaran, Chairman of Singapore Hospice Council,

Dr Seet Ai Mee, Chairperson of Singapore Hospice Council Community Outreach Committee,

Mr Albert Ching, Organising Chairman of Voices for Hospices Charity Concert 2013,

Distinguished guests,

Ladies and Gentlemen,

1. Thank you for inviting me to the Voices for Hospices 2013 Charity Concert. Today is World Hospice and Palliative Care Day, and it is indeed my pleasure to join you on this occasion in support of raising awareness of palliative care. I attended the last concert in 2011 and enjoyed myself thoroughly, and am looking forward to this evening’s performances.

2. Palliative care in Singapore has come a long way. Since 2009, the number of patients benefitting from home palliative care alone has increased threefold, our inpatient hospices have expanded, and our care providers have introduced innovative new services for their patients.

3. Nonetheless, more needs to be done. We expect that with our ageing population, the demand for palliative care will grow further from the 5000-6000 patients per year at present to more than 10,000 per year in 2020. The Ministry of Health is committed to work
hand in hand with providers in this sector to further develop palliative care in Singapore. I want to briefly share with you two areas which we are working on - increasing capacity, and raising the quality of care.

INCREASING CAPACITY

4. Firstly, MOH is working to boost the capacity of both inpatient and home-based palliative care. We need both modalities to provide high-quality palliative care at different points in a patient’s journey, as well as to provide more care options depending on the patient’s circumstances. For inpatient care, MOH is supporting the redevelopment of Assisi Hospice, which will add fifty inpatient beds to its existing capacity, and is also looking to expand palliative care in other healthcare institutions.

5. Demand for home palliative care has also grown rapidly in recent years. From the 1,700 patients receiving home palliative care in 2009, there are now around 5,000 patients on such services today. Many patients want to be cared for and to pass on in the comfort of their own homes, surrounded by family and loved ones. Currently, the majority of patients served by home palliative care are cancer patients. Moving forward, MOH is keen to work with interested providers to expand home palliative care to serve more patients with non-cancer terminal illnesses, such as end stage organ failure.

6. To support all these increases in capacity, we recognise that we will also need to boost manpower for the palliative care sector – both in numbers and training. We are already trying to recruit more healthcare workers into the intermediate and long term care sector through salary increases for clinical, administrative and support staff in VWO ILTC organisations. We also aim to equip all healthcare professionals with basic skills and knowledge in palliative care, and to support further training opportunities.

RAISING QUALITY OF CARE

7. Secondly, even while increasing capacity, we will continue to support providers to raise the already commendable standard of palliative care today. Shortly after the National Strategy for Palliative Care report was released in end 2011, a committee comprising palliative care doctors, nurses and social workers and staffed by the Ministry of Health was convened to develop a set of national standards for palliative care. When completed by early 2014, this will be a reference point for all providers seeking to improve the quality of care for their patients.

8. We are also supporting providers to innovate new services to improve not only the quality of care delivered, but also the patient’s experience. For example, Dover Park Hospice is now piloting an integrated programme which allows for rapid, seamless transfers between the hospital, inpatient hospice and home settings, with patients receiving a response within 24 hours when referred to another setting for care. HCA Hospice Care is also piloting a new dedicated care program for children with life-limiting illnesses.

AWARENESS OF END-OF-LIFE CARE ISSUES AND ADVANCE CARE PLANNING

9. Even as we build up the palliative care sector, it is important too that we empower people to decide for themselves, how they want to live the last days of their lives. The National Strategy for Palliative Care Report recommended that we promote awareness of advance care planning in Singapore. Advance care planning is a series of conversations between healthcare professionals, patients and family members about the patient's preferences for care towards the end-of-life, and what a “good death” means to them. This can ensure that care is given in accordance with patients’ wishes, which improves dignity and quality of life, and minimises stress for family members.

10. Voluntary welfare organisations who work with patients and their families at an individual level are best placed to promote awareness of advance care planning. I am pleased to note SHC’s ongoing work in raising the public’s understanding of end-of-life issues. Last year, SHC launched its “Community Outreach Programme”, and to date, it has participated in and initiated a total of 20 events throughout Singapore. I hope that SHC will continue its excellent work in this area. I am also heartened to learn that a team of eight medical undergraduates from the National University of Singapore’s Yong Loo Lin School of Medicine has launched an island-wide campaign to promote awareness of palliative care. Through an initiative named “Project Happy Apples”, this team hopes to bring to light true stories of patients receiving palliative care. Mervyn, Shawn, Wilson, Kenneth, Angeline, Meng Fei, Zan and Jasmine, well done! You embody the spirit of compassion and volunteerism, and I hope that you will inspire many others to follow likewise.

CONCLUSION

11. We look forward to continuing our partnership with palliative care providers to build up this sector, and I would like to also pay tribute on this World Hospice and Palliative Care Day to all palliative care doctors, nurses, medical social workers and volunteers, for your tireless devotion to your work. I have seen for myself that your work is physically and emotionally demanding, but it is because of you that patients are able to live well till their very last day. Your dedication is truly commendable, and may you inspire many others to follow in your footsteps.

12. Let me also take the opportunity to congratulate the organisers and volunteers on organising this year’s Voices for Hospice Charity Concert. I wish you all a pleasant and enjoyable evening.

13. Thank you.