Speech by Dr Amy Khor, Senior Minister of State, Ministry of Health, at the debate on the President's Address, 16 May 2018

Introduction

1.            Sir, the President spoke eloquently of five thrusts for the government moving into the future, one of which was to forge a caring and inclusive society, leaving no Singaporean behind.

2.            Two approaches to achieve this are (1) tackling inequality by providing the right support to those who need it such as in skills training and employment, and (2) rolling out policies for the growing elderly population such as helping older workers stay employed.

3.            I speak in support of this with special focus on older workers and especially baby boomers, and women at the workplace.

4.            Let me first declare that I belong to the baby boomer generation and am therefore happily classified as an elderly, plus I am a woman.

5.            One barometer of an inclusive society is having an inclusive workplace. This means helping different groups of Singaporeans who are able and willing to work, to stay employed and find fulfilment, even as circumstances change.

6.            An inclusive workplace is not an automatic nor easy outcome. But there are concrete ways the Government and our partners can work towards in order to create and sustain it such as being inclusive in helping mature workers and being inclusive in creating flexible work arrangements which is especially helpful for women. Indeed, these are precisely the outcomes that the Ministry of Health (MOH) is working towards together with our healthcare institutions, for a diverse healthcare workforce, as we expect to increase our healthcare manpower by a further 9,000 between 2017 and 2019 to staff new and expanding facilities in our public healthcare and aged care settings.

Providing support to mature workers

7.            We need to help our mature workers, including the baby boomers who are now entering the retirement phase of their lives, by keeping them active and connected to society.  This way they can age positively.

8.            While some seniors will want to retire to spend time with their grandchildren and hobbies, some will find purpose in continuing their current roles, and others may wish to take smaller bite-size roles.

9.            Some mature workers are also in transition between careers and welcome opportunities in the care sector. We will need to cater to their different wants to keep them integrated in society while playing a meaningful role.

10.         Mr Francis Tan of UOB recently pointed out that this year, 2018, is the first year in our history when the share of the population that is 65 years old and above will match that of those younger than 15 years old. Globally, the trend is also accelerating elsewhere.

11.         The World Economic Forum (WEF) points out that by 2020, the global population of those over 60 years of age will reach 1 billion. By 2050, it is expected to reach 2 billion. This trend, combined with a general decline in birth rates, is leading to a situation where the world’s old will outnumber the young. This is not just a statistical quirk, but a demographic result of great significance.

12.         The consequence of ageing is well documented. Oxford Economics and Haver Analytics posit that there will be sharp deceleration and indeed negative, labour supply growth and Singapore could be among the worst hit in terms of its impact on economic growth.

13.         However, in Singapore, as Minister Chan Chun Sing said on Monday, we should not let challenges define us. Instead we should see ageing as an opportunity to do things differently, or as Ravi Menon, MD of MAS puts it, “Demographics is not destiny”. The good news is that our healthy life expectancy is also increasing, with people staying healthier for longer and there is also an opportunity to better leverage the abilities of those over 60, by adjusting workplace policies and redefining what “retirement” means. 

14.         Seizing opportunities arising from productive longevity, is therefore crucial to Singapore’s success as a nation and is a key priority.   Extending working life and promoting senior entrepreneurship are increasingly perceived as economic drivers.  Fostering both can enable older people to leverage their institutional knowledge, wisdom and insights to continue contributing positively to the community and economy.

15.         For existing healthcare workers who wish to continue in their current roles, we facilitate their re-employment through strategies such as job re-design, training and re-employment facilitation workshops.

a)       Today, 9 in 10 staff at retirement age are re-employed.

b)       The public healthcare sector raised the re-employment age for staff, before legislation kicked in, from 65 to 67 since July 2016.

c)       In the case of nurses, who form the bulk of the healthcare workforce and where we most need manpower, we have also seen an increase in the number of nurses working past the retirement age. In 2017, over 1,400 retired nurses aged above 62 were working, compared to 1,200 in 2015. 20% of them are working part-time. This flexibility supports older nurses so that they can continue to contribute at a pace that they are comfortable with.

16.         Our public healthcare institutions have also implemented workplace initiatives such as elder-friendly features like placing a magnifying glass on medication carts, and larger fonts for signages.

17.         We are also automating some labour-intensive care activities such as lifting and transferring of patients using mobile hoists and bed transporters. This will reduce the strain on older workers, and allow them to continue in their roles.

18.         For those who wish to take on part-time or smaller bite-sized roles, we have also been working with our partners to increase the number of micro-jobs.

a)     For example, several of our public hospitals have created Basic Care Assistant (BCA) positions, where locals with no prior healthcare experience are trained to provide care in areas such as feeding, and patient transfer in the wards on a part-time basis.

19.         For mature workers looking to switch careers, we provide multiple pathways and training, to facilitate picking up of new skills, to join us in our care transformation journey.

20.          In 2017, we supported about 150 mid-career locals through healthcare conversion programmes such as the Professional Conversion Programmes (PCPs) and the Senior Management Associate Scheme (SMAS), to help individuals acquire skills and take on good jobs in healthcare in a variety of roles such as Nursing, Allied Health and Administration.

This is triple the number compared to three years ago.

a)     We enhanced the PCP for Nursing by providing employers with more funding to support the training of mid-career nurses.

b)     Earlier this year, MOH together with the National University of Singapore (NUS) and Workforce Singapore (WSG) also introduced a new degree-level PCP-RN to attract more mid-career Singaporeans into the nursing profession.

This PCP will complement the current PCP-RN (Diploma) programme at NYP and provide an additional pathway for mid-career conversion into nursing. The course commences in July this year, with an estimated inaugural cohort of about 40 mid-career trainees.

21.         We are also working with WSG and e2i on programmes to facilitate employment and transition of mature workers, especially PMETs who may be displaced due to restructuring in other industries, into suitable roles in the healthcare sector. Older workers as a segment of the workforce is not a monolithic group. They are of varying ages, educational background, and circumstances.  While some work simply because they want to remain gainfully employed, others, like Minister Ng Chee Meng said yesterday, need to work as they have expenses, mortgages and dependents relying on them. Hence, I support Minister Ng’s idea of forming a new Tripartite Committee to take a closer and perhaps more granular look at ways to support mature workers to continue working if they choose to.

Flexible work arrangements to cater to different needs

22.         Secondly, we must step up flexible work arrangements to cater to Singaporeans with different needs, especially women. Singaporeans in different life segments and at different life stages have varying needs in their careers. Those starting a family or looking after their elderly parents or grandchildren may be looking to balance their work with family commitments. Many women ask for this support in flexible work arrangement (FWA), and actually the men too.

23.         Adopting flexible work arrangements (FWAs) will help us better cater to the needs of our healthcare workforce at different life stages, and retain them in the workforce, especially our women and older workers, for a win-win.

a)    For instance, we have piloted FWAs for nurses, who are the largest staff group in the public healthcare sector. We have engaged nurses and we know this is important for many of them.

b)    Today, more than 100 wards across the public healthcare institutions have adopted FWA for nurses, in the form of more flexible shift work hours. This helps them to avoid the binary option of either being employed or unemployed.

24.         To further scale up FWA adoption for nurses, the public healthcare institutions will progressively move to electronic rostering (e-rostering) starting from the second half of 2018. This shift will help to support nurse managers in managing more complex shift rostering of staff and empower them to support FWA in a bigger way.

25.         Globally, gender pay gap persists, including in Singapore, although we rank relatively well even among OECD countries, ahead of countries like Australia and the UK.

26.         A reason often attributed to this pay gap is men’s greater share of senior jobs as more women drop out of the workforce due to family caregiving duties.

27.         An article in The Economist (7 April 2018) noted that men’s and women’s salaries start diverging from childbearing years. This “motherhood penalty” is often followed by a “good daughter penalty” when elderly parents require care and daughters often prove more conscientious than sons. Here I am tempted to note that the men just don’t get it. Quoting figures from the UK’s Office of National Statistics, the median pay gap is only 2% among full time workers in their 30s, yet jumps to 14% in their 40s and 16% in their 50s.

28.         As our population ages, a so called “caring economy” is emerging. The need to provide care to the elderly can have a significant impact on the workforce. Working caregivers must often take time off or leave the workforce altogether. As the Economist article highlights, the “caring” economy disproportionately affects women, because they make up the majority of caregivers, which also negatively impacts gender parity. Flexible Work Arrangements such as flexi work hours, work from home, or part time work would better allow caregivers to remain in the workforce.  Besides providing funding support and the Tripartite Standard on FWAs, moving forward, we could, adopting a tripartite approach, help companies who may not have the know-how to implement FWAs, to do so. 

29.         Over the years we have been increasing support for caregivers such as expanding day care and home care capacity, providing caregiver training and training grant, respite care and elder sitter service for dementia patients.

30.         Nonetheless, as our population ages and caregiving needs increase, we must look at more ways to better support caregivers.

Conclusion

31.         Mr Speaker Sir, we have made some progress but we must press on in creating and sustaining an inclusive workplace, so that work opportunities are maximised for everyone who are able and willing to work, and that no Singaporean, young or old, woman or man, is left behind. Policymakers can continue to roll out initiatives to foster and support such an environment but creating a truly inclusive workplace would require individuals and companies – shareholder, management and staff – changing within themselves in terms of mindsets and prejudices, and changing their corporate culture.

32.       Sir, with this I support the motion.