Palliative care sector to get boost to cope with ageing population

Palliative care services to ease suffering in people who are dying will be significantly ramped up over the next six years to cope with Singapore's rapidly ageing population. -- PHOTO: ST FILE
Palliative care services to ease suffering in people who are dying will be significantly ramped up over the next six years to cope with Singapore's rapidly ageing population. -- PHOTO: ST FILE

SINGAPORE - Palliative care services to ease suffering in people who are dying will be significantly ramped up over the next six years to cope with Singapore's rapidly ageing population. There will be more hospice beds, home palliative care services and a new graduate diploma course to train more doctors in this discipline.

People will also be allowed to use more of their Medisave money for these services, with no cap on withdrawal for those who are terminally ill.

Announcing these plans on Saturday, Health Minister Gan Kim Yong described palliative care as "a critical piece in our overall efforts to provide good and appropriate care to help patients age and die in place with dignity."

Speaking at the Palliative Care Conference, he promised that the Ministry of Health (MOH) will invest in developing four areas in palliative care services - enhancing the quality of care, expanding services, ensuring affordability and increasing awareness.

Today, 5,000 people can receive palliative care at home each year. By 2020, at least 6,000 can be cared for this way. The number of palliative care beds will also have more than doubled by then - from 147 beds today to 360 beds. On top of that, he said Community Hospitals will supplement hospices with beds to cater to patients whose conditions suddenly worsen or have other acute needs.

Two regional healthcare groups led by the National University Hospital (NUH) and Khoo Teck Puat Hospital (KTPH) will also train staff in 14 nursing homes with a total of 2,800 beds in advance care planning, geriatric care and end-of-life care.

To make sure people can afford such care at the end of their lives, the MOH will ease the current caps on Medisave withdrawals. From January 1 2015, the daily Medisave withdrawal limits for palliative care will go up from $160 to $200 a day and lifetime limit for home palliative care from $1,500 to $2,500.

But for patients with terminal illness such as cancer or organ failure, this cap will be lifted and there will be no restriction on the amount they can use from their own Medisave accounts.

Mr Gan said that together with the 75 per cent subsidy for hospice care and 80 per cent for home palliative care "we hope patients and their families need not worry about palliative expenses at a difficult time."

The ministry will also change how it funds organisations providing home palliative care. Today, the amount depends on the number of visits. From next month (July 1) and will be based on the number of patients they look after, reflecting a shift in emphasis to focus on outcomes.

Mr Gan explained: "This new approach to funding will deliver a steady stream of financial resources, enabling providers to plan and deliver holistic, patient-centric services. It will also give greater flexibility to test out new models of care for the benefit of patients."

Two years ago, the MOH commissioned the Lien Foundation to draw up a National Strategy for Palliative Care. This was followed by an industry task force led by Associate Professors Pang Weng Sun and Cynthia Goh to draw up National Guidelines.

However, Mr Gan said: "Ultimately, whether we can translate the Guidelines to good palliative care depends critically on the quality of our healthcare professionals."

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