SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH, AT THE THIRD GLOBAL HEALTH FORUM, BEIJING, CHINA, 17 JULY 2024

Professor Margaret Chan, Chairperson, Global Health Forum

Mr Ban Ki-moon, Chairman, Boao Forum for Asia

Mr Yin Li, Beijing Party Secretary

Mr Takemi Keizo, Japanese Minister of Health, Labour, and Welfare

Mr Zhang Jun, Secretary-General, Boao Forum for Asia

Excellencies 

Distinguished guests, 

1.     I am happy to join you today at the Third Global Health Forum of Boao Forum for Asia.

Inexorable, Global and Unprecedented

2.      Today I would like to talk about ageing. Ageing is a phenomenon that is inexorable, global and unprecedented. Inexorable, because the march of time is relentless. Global, because other than Africa and India, practically the entire world is ageing. 

3.      Most importantly, it is unprecedented. Neither Singapore in our short history as a nation, nor China in its civilisational history lasting a few thousand years, has experienced ageing like we are now. Ageing is undoubtedly the biggest social development we are confronting. 

4.      In the initial stage, an ageing population can be treated simply as a healthcare problem. Expand our healthcare capacity and we can meet the additional demand for healthcare by older people. 

5.      But as the process advances, which it will, ageing is no longer just a healthcare issue. It affects almost every facet of modern life, and every aspect of governance. 

6.      Let me talk about some of these major aspects. 

Economic Impact of Ageing

7.     First, there will be an economic imperative for people to work longer. Ageing can become a significant economic drag as the workforce contracts. Many countries, including China and Japan, are already experiencing this. 

8.      Fortunately, while people are living longer, they are also getting healthier and fitter. The Chinese saying “人生七十古来稀”, which means it is rare for someone to live until their 70s, luckily no longer holds true. Many people live to their 80s, 90s or even for a century. 

9.      We simply have to work further into our lives. We cannot be spending the last one third of our lives not being economically active and eating into our savings. Singapore is therefore planning to raise retirement and re-employment ages to 65 and 70 respectively, by 2030. China is doing the same too.

10.      Technology is reducing the need for physical strength which removes the challenges of older people working. Artificial Intelligence can now automate thinking and communications, but at the same time it creates a premium for people good with interpersonal skills which older people also have an advantage. 

Embrace Lifelong Learning

11.      Second, formal education needs to extend to lifelong learning. If people need to work further into their lives, we need to keep up with our skills and knowledge. 

12.      The formal education system is designed for the young to equip them to enter the workforce. This must now extend to a lifelong learning system that becomes part of the education continuum. 

13.      Lifelong learning needs to be practical, imparting skills and knowledge that is relevant to industries and jobs. Learning pathways and delivery modalities need to be flexible. Moreover, we need to recognise that academic qualifications are less important than the accreditation of skills competency. 

14.      Many European countries, due to their historical development of guilds, tradesmen and craftsmen, have a longer tradition in lifelong learning, and competency-based training. Singapore has learnt much from Europe in developing our own lifelong learning system, called the SkillsFuture system. 

Supporting Old Age and Retirement

15.      The third big area, like a timebomb, is retirement adequacy. As the population ages, state-funded old-age support systems are becoming increasingly unsustainable. 

16.      Japan, with almost 30% of its population aged 65 and above, spends over 20% of its national budget on old-age support. Many European countries, such as Italy, Portugal, Greece, and France, spend well over 10% of their national budgets. 

17.      Fortunately, for Singapore, we have inherited a defined contribution system based on personal savings, with contributions from employers and the government throughout a person’s working life. 

18.      We have strengthened the core system based on personal savings with additional old-age support for the low income or those with low savings. We pool together old-age savings to ensure that old-age monthly withdrawals can last a lifetime for everyone.

Anchoring Preventive Healthcare

19.      Finally, the healthcare system needs to be reformed. As a population ages, the capacity of the healthcare system needs to be expanded in tandem. 

20.      Again, this will run into the problem of unsustainability. Fiscal sustainability is only one aspect, as most developed countries are already spending 10% to 12% of their GDP on healthcare, with the US higher, at 17% or more. There is also the problem of finding sufficient doctors, nurses and allied health professionals. 

21.      A sustainable healthcare system for an ageing population therefore must be anchored on preventive care, delivered through primary care. We need to keep our people as healthy as possible. This is not just about giving them the best treatment when they are sick but preventing them from falling sick in the first place. 

22.      To do so, healthcare systems need to be reconfigured – anchored in the communities, and leveraging good doctor-patient relationships. I saw how China does this firsthand, when I visited the Dahongmen Community Health Service Center earlier this morning. 

23.      Health is mostly socially determined, not clinically determined. It is important to ensure seniors are not lonely and isolated. For a senior, every little physical obstacle can become a reason to be alone and isolated. In Singapore, we invested over many years in covered linkways, lifts, ramps in public areas, and other senior-friendly features in public housing homes, to help seniors to be able to get out of their house and get connected with their communities. These are small investments, but for the seniors, it is a big step into the community.

24.      We are investing in Active Ageing Centres all over the island, to engage seniors in social activities and learning. At the community level, volunteers knock on doors, look for lonely seniors, and persuade them to come out of their houses to engage socially. 

Closing

25.      The co-operation between Singapore and China has been comprehensive, high quality and forward looking. We learn from each other and work closely in many areas – economic reform, industrial development, social governance, environment sustainability and other areas. 

26.      Addressing the challenges of an ageing population is another frontier for meaningful co-operation. Today, almost one in four Singaporeans is aged 65 and above. We are ageing 10 to 20 years ahead of China. 

27.      Healthcare is all-encompassing. Therefore, we adopted and adapted the best practices around the world and developed measures to cope with an ageing population. I am sure Singapore’s experience can be useful to China, as China’s experience will be valuable to Singapore. 

28.      I look forward to hearing from fellow participants and their experiences in advancing healthy ageing. Thank you very much.