Why It Matters

Room to test models of care

Plans for a $15 million nursing home in Changi have been aborted after it failed to secure government subsidies.

The project sought to test a different model of care for dementia patients by replacing the usual six- to eight-bed hospital ward layout common in nursing homes here with single or twin rooms with en suite toilets. Such a design is meant to create a home-like environment and provide the residents with more privacy, autonomy and well- being.

However, the Ministry of Health said the Government could not provide subsidies for patients in rooms designed to look like private or A-class wards . The ministry said such subsidies would not be financially sustainable if applied to the rest of the aged-care sector.

This is a landmark case that will have wider implications for many of us who may not have the family support that allows us to be cared for at home when we grow old. Do we expect to have a room of our own in a nursing home, and can we afford it? Two key points should be discussed.

First, are single or double rooms in nursing homes medically necessary, or are they simply frills? This will determine what degree of creature comfort is right for those on government subsidies. Research has established the benefits of having private rooms. Countries like Britain, Japan and Australia limit the number of people in each room to two.

Second, should the same subsidy model apply in both hospital and nursing home settings?

Hospitals' single rooms and B1 wards with four beds receive little or no subsidy. But the average stay in public acute-care hospitals was just 5.8 days in 2012. Perhaps a week in a shared room is fine, but maybe not for the rest of one's life, as is the case in a nursing home.

All these questions matter because our rapidly ageing population, together with changing family structures and higher income levels, means that more seniors will have higher expectations about the level of care they get before they die. This case should prompt us to rethink how to ensure room for innovation while being fiscally prudent.

A version of this article appeared in the print edition of The Straits Times on December 22, 2015, with the headline 'Room to test models of care'. Print Edition | Subscribe