Speech by Mr Gan Kim Yong, Minister for Health, at the 8th International Conference on Social Work in Health and Mental Health, at the University Cultural Centre on 19 June 2016

Dr Goh Soon Noi and Dr Rosaleen Ow, Co-Chairs of the Organising Committee,

Members of the local and international Social Work community,

Ladies and gentlemen,

    Good afternoon. It gives me great pleasure to join you at the 8^th International Conference on Social Work in Health and Mental Health organised by the Singapore Association of Social Workers, and in partnership with the Department of Social Work at the National University of Singapore. To begin, let me first take this opportunity to acknowledge the contributions of our social workers, who are important positive change agents in the lives of individuals, families and the communities they serve. I would also like to extend my warm welcome to our international guests – I was told there are 300 of you here, from 30 countries. Many of you are social workers, healthcare professionals and social service practitioners. Welcome to this conference.

2    I am indeed encouraged to note that the theme for this year’s conference is, “Enhancing the Human Condition: Negotiating and Creating Change”. This theme is particularly relevant for the changing realities that confront the social work landscape here in Singapore and around the world.

The Case for Change

3    Singapore, in particular, is ageing rapidly. By 2030, about one in four Singaporeans will be aged 65 and above. Our population is also living longer, with an average life expectancy of 80.4 years for males and 84.9 years for females in 2015. Women live longer than men. Rapid ageing and an epidemiological shift from communicable to non-communicable and chronic diseases will lead to an increase in healthcare demand.

4    While our healthcare system had served us well previously, episodic and organ-focused care arrangements delivered by different healthcare providers and in different, separate care settings are no longer efficient for the ageing population with increasingly complex chronic conditions. This will lead to potential gaps in patient management and sub-optimal use of resources. We need to reshape our healthcare delivery system from one that is built around hospitals to one that is person centric. This shift needs to be supported by good system integration and strong community partnerships between providers in the healthcare and social care service sectors.

Integrating Health and Social Care Delivery

5    Coordinating care for patients with inter-related health and social issues is a global challenge. Compliance to medical treatments is often heavily dependent and influenced by the biopsychosocial environment of the patient. The health and functional status of active agers depends on the social support they receive. In Singapore, we have moved towards team-based and community-based care by strengthening the collaboration of care providers within and across the Regional Health Systems that span from the acute care to primary, intermediate, long-term and home care sectors. Through coordinated assessments of care needs by multi-professional teams, we aim to deliver holistic care plans that take into account both the medical and social needs of the patients.

6    In 2013, we merged the aged care functions of the Ministry of Social and Family Development (MSF) with those of the Ministry of Health (MOH). While the two ministries continue to work closely together, merging the two portfolios under a single roof has facilitated service planning and sector development at the national level. This transition also enabled aged care service providers to broaden their scope to include services across the health and social aged care spectrum. As a result of the merger, seniors with multiple care needs can receive care that is more integrated as they need to contact just a single operator, the Agency for Integrated Care (AIC), to coordinate their care services.

7    The merger has also allowed us to innovate and pilot new models that integrate social and health care. One example is the new Community Networks for Seniors (CNS) pilot which will comprise at its core, a small team of full-time officers who will identify the health and social needs of seniors and draw together local stakeholders such as VWOs, community partners, volunteers, schools and businesses, to provide coordinated support for our seniors. Another example of how we are developing innovative models of social and health care is our new Active Ageing Hubs (AAHs). AAHs combine active ageing programmes for ambulant and healthy seniors, with day care and rehabilitation services for seniors with more care needs, along with assisted living services such as home monitoring. By providing a continuum of health and social care services, these facilities will provide holistic support for seniors to live independently in the community, even as their needs change over time.

8    The Government has also taken a significant step in building a more coordinated system of social support by establishing 24 Social Service Offices (SSOs) island-wide in the last two years to bring social assistance services closer to the community. We are also expanding the Community Befriending Programme from 15 to 50 constituencies to provide psycho-social support and reduce the risk of social isolation for seniors living alone.

9    Volunteers play an important role in helping seniors to age in place. Montfort Care has trained a group of volunteers known as the Angel Ambassadors. These Angel Ambassadors are working closely with the Eastern Health Alliance’s Neighbours Programme to befriend and support residents in Marine Parade to address their health and social needs. During regular home visits to the seniors, the volunteers will help to keep a lookout for the seniors’ health, remind them on follow-up appointments and inform the health care partners if more help is needed. Volunteers are also trained to recognise signs and symptoms of depression, dementia and other mental health issues. Such collaboration between the social and health care sector is important in providing better integrated care and support for the seniors to age well in the community.

10    The same integration is happening in the delivery of community mental health services too. The social workers in the senior activity centres are trained to provide outreach and early recognition of depression and dementia, to offer basic emotional support and service linkages. AIC is also collaborating with the grassroots leaders, social service agencies, government agencies, mental health VWOs and the restructured hospitals to build local community support networks.

11    In Kembangan-Chai Chee, for example, grassroots leaders formed a social team to support the needs of the residents. Often, the residents require both social and health care services such as financial, housing, physical and mental health assessment, intervention and community support. To date, the team has supported over 110 residents with complex social and healthcare needs in Kembangan-Chai Chee area.

12    Besides improving the efficiency and effectiveness of our healthcare and social support systems, our healthcare financing system is also designed to assure affordability and sustainability in the long term. The 3Ms, namely Medisave, MediShield Life and Medifund, and Government subsidies work hand-in-hand to ensure that Singaporeans have access to good and affordable healthcare. The MediShield Life is now a mandatory basic universal insurance scheme that protects all Singaporeans against the risks of large hospitalisation bills.

13    With the focus of Singapore’s healthcare shifting towards primary and community care, the people will, now more than ever, need the continued support from social workers in navigating the healthcare and social support systems to better manage their conditions and live healthier lives.

Developing Social Workers for the Future

14    To support the reorganisation of our healthcare system, we need to shift our healthcare workforce profile and skillset towards more “community and generalist” skills. We would need to re-assess and re-define the roles that healthcare providers play, upskill their competencies and capabilities and move beyond institution-centred healthcare practice to patient-centric community based care.

15    The social work profession has over the years, gained recognition for its value in addressing complex biopsychosocial issues. Nevertheless, social workers need to articulate the value they bring to the multi-disciplinary team they collaborate with, and the value of their roles in helping patients and their caregivers cope with the impact of medical conditions.

16    To provide clearer articulation of social work roles and competencies, MOH and MSF had jointly developed the National Social Work Competency Framework. With this Competency Framework launched last year, the social work fraternity can now take bigger strides forward to meet the changing healthcare and social demands. It has also identified behavioural competencies required of all social workers, such as the ability to empower clients and their caregivers to achieve self-sufficiency and the ability to enable solutions and influence change through strategic partnerships.

17    The Competency Framework will also provide guidance to the development of sector-wide competency-based training to equip social workers with the necessary knowledge and skills. The Social Service Institute (SSI), in collaboration with MOH and MSF, had developed a new five-day National Social Work On-Boarding Programme for junior social workers. This will give them an appreciation of the importance of health and social care integration, and create professional networking opportunities across sectors. MOH and MSF are working together to develop more courses and initiatives to build a multi-disciplinary social work fraternity.

Conclusion

18    In closing, I am encouraged to know that one of the principles of social work ethics is to strive to remain proficient in professional practice and competencies. Your commitment to lifelong learning and professional development is highly commendable. I look forward to exchanges between researchers and practitioners to inspire new ideas and approaches to drive the development of social work for health, physically and mentally. For our international friends and guests, we hope that you will also find time to look around, to spend time in Singapore and have a great time to enjoy the sights and sounds, as well as the great food that Singapore can offer.

19    I wish you a fruitful conference ahead. Thank you.