Singapore has sufficient capacity currently to meet demand for aged care, the Ministry of Health (MOH) said in a statement yesterday. But it will continue to grow services to cater to a greying nation.
In response to a Lien Foundation report which said the Government has not provided enough facilities or subsidies for the rapidly ageing population, the MOH said it is "on track to meeting our targets of 6,200 daycare places, 10,000 home care places and 17,000 nursing home beds by 2020".
The report, released yesterday, gave the example of how referrals for daycare at one centre outnumbered the capacity nationwide. It also cited how the median waiting time for general daycare was about 20 days, while that for dementia care was about 35 days.
The study also found that more seniors are being cared for outside of hospitals and nursing homes - 14,000 people used subsidised home and centre-based services last year, up from 12,000 in 2016.
In contrast, the number of residents in subsidised nursing homes had remained stable at around 10,000 in the past two years, signalling a shift in the main mode of long-term care for seniors.
The Lien report stressed the importance of preventive care, citing how a rapidly greying Singapore could see the number of people aged 65 years and older doubling to a million by 2030.
Key findings of Lien Foundation's aged care study
The Lien Foundation released a report yesterday on home and community care for seniors in Singapore. The study was based on responses from 103 individuals, including interviews with 50 non-profit and private-care provider representatives, government representatives, experts on ageing and caregivers.
In it, the authors highlighted several areas the sector could focus on as more elderly folk opt to age at home rather than in hospitals and nursing homes.
The Ministry of Health (MOH) is expected to hit its target of 6,200 daycare places, 10,000 home care places and 17,000 nursing home beds by 2020. But even as MOH continues to grow capacity, question marks remain over whether the numbers will be sufficient.
For example, the number of referrals by the Agency for Integrated Care was already at 7,800 for daycare services in 2015. Last year, the number of daycare places was reportedly 5,000.
Home care for a severely disabled person can cost as much as $3,100, while the median cost to stay in a voluntary welfare organisation nursing home is $2,100. Households which have a per capita monthly income of $2,601 and above do not qualify for subsidies. The study called for more help to lower costs and a cap on the fundraising burden for non-profit providers.
Separately, the study found that MOH's spending on long-term care rose significantly in recent years, hitting $800 million in 2016, which is $200 million more than in 2015. But the $800 million was only 8 per cent of the healthcare budget and 0.19 per cent of Singapore's gross domestic product for the year. In comparison, developed nations in the Organisation for Economic Cooperation and Development spent an average of 1.4 per cent of their GDP on long-term care in 2014.
There are currently about 11,000 workers in long-term care. The report, while taking into account MOH's $24 million investment to attract talent, highlighted how Singapore needs to increase that number by at least 45 per cent, with the biggest demand for direct-care workers.
MORE REGULATION IN ELDERCARE
There are around 60 private providers, but only two are regulated. Unlike nursing homes and childcare centres, home and centre-based care is not licensed in Singapore. All providers that receive government funding are subject to certain mandatory service requirements stipulated by MOH.
It also cited key focus areas such as funding, capacity, affordability, manpower and regulation that the Government could look at to upgrade Singapore's home and centre-based care services.
In its statement, MOH said the Community Networks for Seniors (CNS), which involve government bodies, voluntary welfare organisations and volunteers teaming up to visit seniors, were set up to help seniors age in place.
Silver Generation Ambassadors also reach out to seniors, linking them up with befriending services as well as social and healthcare support for the frail.
Under the umbrella of CNS, more than 360 neighbourhoods hold weekly active ageing programmes.
By the end of April this year, more than 7,000 seniors had had their eyes, teeth and hearing checked.
MOH said: "Going forward, we are reaching out to more community partners to make active ageing programmes and functional screening more accessible to seniors in the community."
It said the ministry recognises the important role played by caregivers, and offers respite options from weekend care at 11 eldercare centres, to longer-term care from several days to a month at more than 40 nursing homes.
But it agrees that more can be done to help caregivers, and is working on more options and better support.
The Lien study also found that cost is a concern, pointing out that while the majority of people want to age and be cared for in the comfort of their own homes, rather than in institutions, the costs of community care can be considerable.
MOH replied that there is up to 80 per cent subsidy for seniors who qualify, and for those who still cannot afford such care, Medifund will step in. The Government has already increased its spending on the eldercare sector, from $1.3 billion in the four years from 2007 to $5.1 billion in the four years from 2012.
It has also committed $2 billion to support the proposed CareShield Life scheme, in premium subsidies for the long-term care insurance which pays at least $600 a month for those who are severely disabled.
MOH said it welcomed the Lien report and will study the views and ideas raised.
An author of the study, National University of Singapore (NUS) Associate Professor Elaine Ho, hopes that action can be taken sooner rather than later.
She co-authored the study with fellow NUS Associate Professor Shirlena Huang. Both are from the Geography Department and Social Service Research Centre.
She said: "If we want to be sustainable as an ageing society and age healthily and happily, we actually need to put in the steps now rather than wait for the demographic explosion to take place."
Correction note: This article has been edited for clarity.