Ageing with Purpose; Support for Care-givers

Mr Kwek Hian Chuan Henry (Nee Soon): Mr Speaker, Sir, on behalf of parliamentarians from PAP Senior Group or PAP.SG, I beg to move*, "That this House calls for a whole of Singapore effort to ensure that Singaporeans are able to age with purpose and dignity, stay healthy and connected, and be financially stable to look forward to their years ahead."

*The Motion also stood in the names of Miss Cheryl Chan Wei Ling, Miss Cheng Li Hui, Dr Lily Neo, Ms Joan Pereira, Ms Rahayu Mahzam.

Mr Speaker, preparing Singapore for ageing is one of the most consequential topics for us. We are not talking about niche policies affecting some people. We are talking about how we collectively care for parents, grandparents and other seniors whom we cherish. We are talking about how we will be cared for, when we ourselves age one day. That is why 24 Members of Parliament and several office holders will be speaking about Motions on Ageing and Care-givers today. Because the stakes are that high.

What do we Singaporeans want? For most of us we want to see the entry into our golden years as the start of a new chapter. One in which we can age with dignity, purpose and peace of mind. One in which employment opportunities are flexible and that leverage on our past experiences.

We want to continue to learn new things, contribute meaningfully and are appreciated. We want to take life at a slower pace if we wish to, a life that is rich in meaning and where we can spend more time with family. We want to have the assurance that our healthcare needs are taken care of. And we know that we can count on the support of the Government and community when we need it.

Now, the big question is how. How can we achieve all of this, when so few societies worldwide have succeed, in a sustained way, through generations.

Over the past six months, Speaker Tan Chuan-Jin, as Chairperson of PAP.SG, Ms Joan Pereira, my fellow Vice-chairperson, our exco members and I did some intense consultation to explore what more can be done. We engaged well-regarded experts in the healthcare and the ageing space, and leaders from both the Merdeka and Pioneer Generations. We sought views from seniors from all walks of life, race and religion. We conducted 15 forums and luncheon discussions – organised in the open-ended approach similar to that of Our Singapore Conversation (OSC). We received online feedback, and many written submissions. These are our insights.

One, while an ageing society brings serious challenges, ageing should not be preceive as a problem that must be solved. Ageing also brings many exciting and positive possibilities for Singapore. Indeed, a society can thrive and age well if it has the political will to put in place the right long-term policies. Given that thinking long-term is a hallmark of Singapore, we should aspire to build Singapore up as one of the best place in the world to age. Therefore, we should boldly reframe our narrative and establish a positive agenda.

Two, all of us must own our future and work together – the Government, the people and the private sector. No single group can succeed without the others moving together. We must endeavour to age well as individuals and as a nation.

Three, given the diverse and evolving needs of current and future generation of seniors, the Government must continue to engage. We found the OSC approach useful, because it build trust, deepens engagement and generates ideas.

Four, many seniors find purpose in work. We must create more, and more varied, work opportunities for our seniors, as long as they want or as long as they are able to. And the key is to adopt a sector-by-sector approach and to tap on our tripartite partnership.

Five, our seniors, particularly the Merdeka Generation, have a wealth of experience. They want to actively volunteer their skills and time, and not solely be beneficiaries. The Government can encourage and empower more seniors to step forward, especially through SG Cares.

Six, our Government can do more to support ground-up communities of seniors and explore increased use of dialects to better relate to our seniors. We recommend more age-appropriate facilities and communities for our seniors to exercise and do sports.

Seven, we must continue to strengthen the retirement adequacy of our current and future seniors, including gradually raising CPF for older workers to levels similar to that of younger workers, when the economic conditions allow for it. We can give better incentives so that seniors choose to defer their CPF LIFE withdrawals, giving them bigger future payouts and increased retirement adequacy.

Eight, we must strengthen family support for seniors. We recommend the Government to review the definition of families, to include extended families. If extended family members wants to provide support for seniors, our policies should not be obstacles.

Nine, we need to do more to support our care-givers. Dr Chia Shi-Lu's Motion held concurrently today will address that.

Ten, we can further evolve our housing policies, especially by integrating public homes with affordable assisted living services. The Government can facilitate the creation of group homes within public and private estates to enrich the housing choices available.

We have put our views into a position paper, which we have submitted to the Government. In today’s debate, these 10 points will be elaborated by all of my fellow PAP.SG Members – Ms Joan Pereira, Dr Lily Neo, Ms Tin Pei Ling, Ms Rahayu Mazam and Miss Cheng Li Hui – as well as PAP Members passionate about senior policies.

At this point, let me put forth an important caveat. Our recommendations build on the excellent work already achieved. Indeed, our seniors have been at the forefront of our Government’s and PAP’s agenda. We can see it through at least four ways.

One, since 1984, eight Ministerial and white papers as well as three PAP.SG position papers have been tabled, each calling for and dedicating significant resources to prepare Singapore for ageing.

Two, since 2011, our healthcare spending increased by two and a half times, from slightly over $4 billion to more than $10 billion a year, and it will continue to grow. In magnitude, I believe we are undergoing the most aggressive healthcare expansion and transformation in any developed country in recent memory.

Three, over the past two terms of Government, we have re-forged our healthcare financing, retirement, social and public assistance system to the benefit of our seniors.

Four, we have set aside three billion dollars for the 2015 Action Plan for Successful Ageing, a plan remarkable for its ambition and scope, which calls for Singapore to be a Kampong and City of All Ages, with opportunities for our seniors.

Therefore, our debate today builds on the tremendous work of respective governments.

Now that I have set the context of this Motion, let me spend the rest of my speech on three issues: (a) improving work opportunities for our older workers; (b) strengthening our seniors' retirement adequacy, and (c) enhancing local coordination to serve our seniors.

First, work opportunities. Many seniors find purpose in work. Here are some interesting views we have heard: one, does it make sense for companies to value us one day before our 67^th birthday, and then write us off the very next day? Two, we want to continue working, because it gives us a sense of purpose. But we hope to do it on our terms. Three, age is just a number. We should move away from age as a proxy for the ability. What matters more is health status, our state of mind.

At the same time, we hear other viewpoints: some seniors work to stay financially independent, or to supplement their income; others work because they need a certain amount of money to retire with dignity.

Given such diverse views, we believe Singapore’s objective must be: to create more, and more varied, work opportunities for our seniors, as long as they want, or as long as they are able to.

How does reality match up to this objective? The current picture is a positive one. Today, we are ranked 11^th among 35 OECD countries for employment of older workers. Our success lies with several broad-based policies. We offset employers’ cost of hiring older worker through the Special Employment Credit. We supplement the income of our older low-wage workers through the Workfare Income Supplement scheme. We raised the retirement and re-employment to 62 and 67 respectively. We have tightened standards for companies to bring in non-Singaporeans.

But there is always a higher mountain to climb, a higher peak to aspire to. We believe there is room to evolve our approach. Moving forward, the solution is not to solely depend, or even largely depend on put more legislation compelling firms to hire more seniors. This is not sustainable. Rather, we must create win-win situations so that older workers benefit, companies benefit and Singapore benefits, for both today and tomorrow.

Therefore, we recommend a sector-by-sector, tripartite approach to systematically apply the policies to create more full-time and part-time for our seniors. And we must also help older workers better access freelance opportunities.

Let me start by talking about full-time opportunities. Especially within fast growing industries like IT, healthcare, logistics and transportation, there is room for more full-time jobs for our older workers.

We must put employment of older works firmly on the agenda of these industries. More focused discussions, and sharing of success stories, at the sector and industry level. And through these focused discussions, we must encourage companies and unions to tap on: (a) ob-redesign grants to automate jobs, so that older workers can handle easily; (b) training and internship grants to onboard older workers from other industries; and (c) HR grants to implement policies friendly to workers who are older.

Over time, we hope that all 23 industry transformation maps will do the same.

Of course, some will call this approach incremental. But I see nothing wrong with that. Incremental policies, if pursued diligently and intelligently, can yield solid and sustained results. And this approach draws on Singapore’s strength, which is the strong spirit of partnership between our union, companies and Government.

Next, we call for all companies to adopt Flexible Work Arrangements (FWA) when possible. This helps older workers who desire to work, but on the terms and pace that they are comfortable with. By FWA, we mean: flexible locations, flexible time and flexible load.

We have made good progress. MOM's recent Conditions of Employment survey shows firms offering at least one formal FWA increased to 53% from 50% in 2017 and firms offering at least one ad hoc FWA increased to 84% from 75% in 2017, which is a big increase.

Still, we should aim higher. We should encourage the vast majority of companies to create many more formal FWA roles. More FWA roles mean more part-time jobs, and benefit our older workers. Adopting FWA helps companies too. They can retain and hire talented older workers who prefer or require FWA. They will be well positioned to navigate through our constrained labour market.

Also, as Singapore continues to strengthen our social services, we call for the Government to create more part-time opportunities.

For example, there can be more part-time roles, such as adjunct teachers, Senior Generation Ambassadors, medical befrienders, community organisers, assistant to visiting nurses and enforcement officers.

The Government already does some of this. But we call for a whole-of-Government approach to adopt FWA. It will also free up more young Singaporeans for the private sector. Doing this is not rocket science. We just have to put our heads together and take this to the next level. PAP.SG further calls on our companies, unions and Government to study other countries’ experience in promoting FWA, including legislation on "right-to-ask" for FWA.

Next, we need to empower our older workers to access freelance opportunities. The rise of the platform economy, also called the gig-economy, creates more freelance opportunities for our older workers. Let me share three examples.

One, food delivery services such as Foodpanda and GrabFood. Just last week, Janice Tai from The Straits Times estimates that there are more than 600 seniors doing freelance food delivery.

Two, Thomson Medical Center (TMC). TMC builds on on Singaporean women's own experience as grandmothers and mothers, and equip them with latest health and confinement culinary skills, and then place them as freelance confinement nannies. TMC is supported by Government training grants.

Three, Singapore Consultancy, a new social enterprise. It helps older PMETs from the financial sector transit into freelance consultants, board directors and even advisors to charities. It has received support from WSG's Professional Conversion Programme and Singapore Consultancy is a model worth encouraging.

We expect the platform economy to grow, but older workers need more help to access these freelancing opportunities.

Take the food delivery business as an example. On the ground, I sometimes meet very fit seniors in their late 60s and even 70s who want a job, but cannot get one. At the same time, major food delivery companies have no upper age limit, because they do not see significant differences in performance and safety records between younger and older freelance workers. Yet, out of more than 6,000 riders that Food Panda has today, only 1% is above the age of 60.

Surely more can be done. We call for WSG, e2i and unions for Self-Employment-Person (SEP) do more to teach our seniors digital literacy, and direct suitable healthy seniors to these opportunities, including through digital platforms such as the new NTUC-IBM portal. Beyond food delivery, there are many other freelance opportunities, especially in professional services, as well as F&B industries.

For some older workers, the reality is that it will be hard, though not impossible, for them to get full-time opportunities. Therefore, we recommend WSG and e2i to not just position older workers for full-time jobs in their current sectors, but also help them identify transferable skills for part-time and freelancing opportunities in other sectors.

In addition, the Government and SEP unions can jointly create a positive environment for SEPs through ensuring fair contracting terms, strengthening medical coverage, improving access to training grants and facilitating CPF contributions.

We can also do more to remove obstacles for our older workers to continue working. In particular, certification tests are becoming necessary for more jobs. Some older workers fail these tests, and have to downgrade to lower paying jobs. Therefore, we call for the Government to encourage best practices for testing seniors. These can include using larger fonts in tests, providing seniors with more time for computer-based tests, allowing seniors with relevant working experience to take written or oral tests in Chinese, Malay and in Tamil.

In addition, we should also equip our workers from 40 years old onwards with future skills, after which it may become progressivly harder to learn radically different skills.

A good example is SkillsFuture's tech-skill accelerator programme, which has recently incoporated future skills such as deep machine learning. Can we have more similar programmes?

Next, retirement adequacy. With longer lives and a smaller families, Singaporeans need to save more and plan better for retirement. Especially for workers above 55, and self-employed persons who do not contribute to CPF special account. We have five recommendations.

First, the Government can gradually increase the employers' CPF contribution rates for older workers beyond age 55 to levels similar to that of younger workers, when the economic conditions allow for it. Some employers have indicated concerns about this, therefore a measured way to do this is important. But it is the right thing to do.

Second, we support the recommendation by the Tripartite Work Group on SEP to collect MediSave contributions more seamlessly. Over time, we should consider asking SEPs to build up their CPF Special Account.

Third, we encourage the Government to give better incentives so that seniors could choose to defer their CPF LIFE withdrawals, giving them bigger future payouds and increased retirement adequacy. CPF’s interest rate is already higher than market interest rates and this is already a natural incentive. But can more be done?

Four, we recommend continued support for low-income seniors through the Workfare Income Supplement (WIS) Scheme and the Silver Support (SSS) Scheme.

Five, we recommend the Government to accelerate collaborations with community partners to help Singaporeans plan for retirement. We call for POSB and NTUC to consider setting-up a Thrift-and-Loan cooperative for seniors.

Lastly, let me touch enhancing local coordination to serve our seniors. I believe the frontier of social work in Singapore, including caring of our seniors, lies in helping those in need in a multi-pronged and integrated manner; getting the community to step in when the family nucleus fails; solving issues upstream through policy and community intervention, and shaping societal norms that is caring and empowering.

We at PAP.SG believe strong local coordination is critical to acheive these goals. At the local level, because we have a holistic view of the various needs, we can seek both local and national resources to meet these needs.

So, today, some of my PAP colleagues will also share on their local efforts. Putting a spotlight on these programmes will hopefully create a cascading effect nationwide. Let me first touch on Kembangan-Chai Chee, the constituency that Speaker Tan Chuan-Jin serves.

Kembangan-Chai Chee has intergated social work efforts, where their volunteers work with VWOs and agencies. Here are two of their many programmes, where seniors in need are involved.

One, meal delivery for people in need. Volunteers from there work with various organisations to provide low-income families, including the elderly, with meals 24/7 365 days a year – let me stress again: 24/7, 365 meals a year. As of now, they have more than 450 recipients receiving lunch and/or breakfast.

Two, help for families with mental health issues including hoarding. The team from Kembangan-Chai Chee partners with AIC and IMH, and acts as their ground volunteers. As we all know, cases involving families with mental health issues are usually complex. They also frequently involves seniors. It takes time, many partners to collaborate on each case, but the volunteers there press on to do the necessary.

In Henderson-Dawson where Ms Joan Pereira serves, residents also work with willing hearts to provide daily meals to fellow residents in need, including many seniors.

Now, let me share about what we do in my constituency, Kebun Baru. For our frail and socially-isolated seniors who need help, our team of volunteers from Project Starfish are able to assist every single of them through:

One, regular befriending by well-trained volunteers, who work with agencies and VWO to meet the needs of seniors. They are supplemented by parents and students from our local schools. This is on top of what Community Network of Seniors and social workers do.

Two, regular free meal delivery service through our partner Mummy Yummy.

Three, regular, healthy, communal meals through HPB's Share-a-Pot programme.

Four, comprehensive medical attention through our free medical clinic, which has the organisational and nursing support from Mount Alvenia Hospital.

Five, stepped-up patrol by Police to the houses of the most frail seniors living alone.

Next, for our seniors at Kebun Baru who are looking for a place to bond and do exercise, we have set up a Senior Activity Centre through the kind assistance of Methodist Welfare Services. Two local churches have also opened up communal space for our seniors.

For seniors with medical needs in Kebun Baru, we have recently started a cancer support network, so that cancer patients and family can get the right information and peer support from their fellow residents, some of whom are cancer survivors themselves. We are also working with the Alzheimer's Dementia Association to build a dementia-friendly Kebun Baru. Moving forward, we would like to work with Active SG to bring in more communal sports, especially for our senior men.

I look forward to hearing about other local efforts from members of this House.

In conclusion, Mr Speaker, Sir, I have spoken about boldly reframing Singapore's narrative on ageing, and establishing a positive agenda. I also spoke about creating work opportunities and strengthening retirement adequacy for seniors. Lastly, I spoke about how effective local coordination can help us better care for and empower our seniors. Ultimately, I hope that all Singaporeans can realise that we can collectively build Singapore up, as one of the best places in the world to age.

Dr Chia Shi-Lu will now put forth a Motion about supporting our care-givers.

Question proposed.

Mr Speaker: In accordance with the decision of this House to jointly take this Motion and the next Motion standing in the name of Dr Chia Shi-Lu, I will now call Dr Chia to move his Motion and make his opening speech before allowing Members to debate on both Motions. Dr Chia.

12.28 pm

Dr Chia Shi-Lu (Tanjong Pagar): Mr Speaker, I beg to move* "That this House recognises, given our rapidly ageing population, the important role that care-givers play in helping our Singaporeans age with dignity, and calls on the Government and the community to continue strengthening support for care-givers." I do so with the support of fellow Members of the GPC for Health, Dr Lily Neo, Mr Christopher de Souza, Mr Murali Pillai, and Ms Tin Pei Ling.

*The Motion also stood in the names of Mr Christopher de Souza, Mr Murali Pillai, Dr Lily Neo and Ms Tin Pei Ling.

Why are we focusing on such family care-giving or informal care-giving? Over the course of Chinese New Year festivities last week, as I made my way through rounds of family and constituency celebrations, I was heartened to observe strong family ties and the special care paid to the elderly. Gatherings are centred around the seniors, with extended family members coming together to pay their respects to their 长辈, or their seniors – grandparents, granduncles and grandaunties: "恭喜发财, 身体健康". All of these were said with sincerity and with genuine well-meaning.

Many seniors, thankfully are still hale and hearty, but some have clear disabilities, which is not surprising as it has been estimated that as many as one in three Singaporeans will suffer a period of significant disability in their lifetime. But in every situation the infirm elderly were treated with care and respect, with love and concern and quite naturally so, showing that such care-giving has already become part of the fabric of the tapestry that is family.

Traditional values are still strongly held in our society and the family remains the first line of support. A majority of Singaporeans prefer to care for elderly family members themselves. This is the same whether you are Chinese, Malay, Indian or Eurasian. Fewer seniors are placed in institutional care and this is only usually due to extenuating circumstances.

Our seniors also prefer to stay in familiar surroundings near or surrounded by their children and grandchildren. The desire to experience "天伦之乐" or the joy of family ties, is universal. This arrangement is mutually beneficial for the young and old. As our children participate in the process of providing care for the elderly, they imbibe important values, such as filial piety, responsibility, respect, compassion and empathy. They learn most and they learn best from our personal examples.

Our population is ageing rapidly. As our family sizes shrink and life expectancies increase, the task of care-giving for elderly members will become more challenging. The load on each care-giving party will become heavier and the last lap for each senior is expected to last longer. While we all aim to help our seniors stay healthy for as long as possible, we must also prepare for frailty, a growing chronic disease burden and the prevalence of dementia. In view of the rising needs of family care-givers, it is timely for us to review areas of support for care-givers. We need a whole-of-society approach – the Government, the community, families and individuals. We all have a part to play in supporting care-givers and our seniors.

According to the last available data on care-giving from the Department of Statistics, in 2010, close to three-quarters of our care-givers are working. This means that they have to juggle work commitments, family responsibilities and care-giving.

The 2013 MCYS Survey on Informal Care-giving also found that for working care-givers, in the period of six months prior to the survey, 29%, close to one-third had to leave work at least once for the care recipient's doctor's appointment and 10% indicated that they went late to work over the same period for care-giving commitments.

Care-giving certainly had a negative impact on these working care-givers. How can we then help these care-givers in an increasingly competitive and demanding work environment?

First, we can consider legislating a certain number of days for paid and unpaid care-giver or eldercare leave. The Nordic countries, Australia and Canada already offer paid leave for working care-givers. In Singapore, paid leave is only for childcare. Employees may also tap on six days of unpaid leave for infants.

More importantly, we should focus on Flexible Work Arrangements (FWA). I would think that compared to the occasional days of eldercare or care-giver leave, FWA has a greater impact on a care-giver's ability to continue working. In fact, a body of research in OECD countries have found this to be exactly the case. We must support those who would like to remain in the workforce. Otherwise, not only would our economy suffer from the loss of their skills and knowledge, their loss of income would have a negative impact on their families' finances and their own futures as seniors.

MOM should consider committing additional resources to speed up the adoption of FWA and to increase awareness among job seekers and employees of companies with FWA.

I understand that under the Enhanced Work-Life Grant, companies can already apply for grants and incentives to implement job sharing and FWAs, such as flexi-load, flexi-place and flexi-time. May I ask the Minister of Manpower how the take-up rate has been so far, and? And, what plans are there to accelerate the implementation of FWA, particularly among SMEs?

One of my concerns is that companies may be deterred by the amount of administrative work and changes to work processes in order to integrate FWA. Another obstacle would be the additional financial costs to the company. For example, for job sharing, a company would have to hire two instead of one worker. Due to the cap on CPF contributions, it may cost a company less to hire one full-time worker than to hire two, each with correspondingly lower salaries but which attract employer CPF contributions below the cap. Similarly, employers may have to pay double for employees' insurance premiums. It would be helpful for MOM to have dedicated liaison officers to examine all these potential roadblocks with interested or perhaps with targeted companies and work on overcoming these barriers together.

So far, the implementation of FWA has been employer-centric. I wonder if it is possible for the FWA framework to become more employee-centric. For organisations which are not proactive, what can employees do? Would the Ministry consider setting up a channel to enable employees to appeal for FWA to MOM directly? Upon receipt of such a request, MOM may then send a liaison officer to discuss with the company the viability of FWA and share the successful experiences of other companies.

Next, I would like to appeal for greater support for respite care, particularly emergency respite care.

Respite care schemes provide much-needed temporary breaks for care-givers. Although most families choose to take care of their elderly, there would be times when the emotional and physical demands of such care-giving take their toll, especially when the seniors suffer from poor health or mental issues.

Planned respite care offers the opportunity for care-givers to rest and recharge. Research overseas have also shown that regular breaks from care-giving is beneficial to family care-givers' health and well-being, and reduce conflict between spouses and also between family members. Respite care can also help to reduce abuse or neglect of the elderly and delay or prevent seniors from being sent to institutionalised care subsequently.

While there is already a number of respite care services, both in-home and at day-care centres and nursing homes, I would like to suggest that we invest in more respite care facilities located strategically in every housing estate. Ideally, these centres should be located near Senior Activity or Residents' Centre and are hence both convenient and familiar to both care recipients and their families.

We should also consider allowing families to pre-register and list essential health, medical, financial and payment details so that in the event of an emergency or an urgency, such as a hospitalisation or perhaps an overseas work trip or holiday, families can place their seniors in these centres with peace of mind. These centres should also be linked so that if they have no vacancies, they may make referrals to the nearest centres. I understand that the United Kingdom and Australia already have such systems in place.

Finally, to ensure that the fees of these centres remain affordable, I would also like to propose that the Government takes the lead in the ownership and operation of many of these centres to reap the benefits of economies of scale. Private companies and non-profit organisations can continue to run similar set-ups to provide a wider range of choice for families.

In various surveys of care-giver concerns, the one issue that keeps on sticking out is financial stress. It is expensive to be a care-giver.

Over the last few years, the idea of providing an allowance to family care-givers has surfaced episodically. While the Government provides subsidies for home and community care through schemes such as Silver Support and the Senior Mobility and Enabling Fund (SMF), care-givers still have to incur out-of-pocket costs for consumables, medication, transportation and others. For those who have left their jobs and to look after the elderly full-time, additional financial support would be helpful and is, in fact, needed.

The concern here is over the long-term financial sustainability of paying family care-givers as the number of elderly increases even as the number of Singaporeans in the workforce shrinks. Countries which implement payouts, such as United Kingdom, Australia and Hong Kong, limit this benefit to lower income care-givers or to care-givers with no other sources of income. The Government may wish to consider providing allowances to only full-time family care-givers who are in the lower income groups and who look after seniors with long-term disabilities, a more calibrated approach. Mr Speaker, in Mandarin, please, on empowering care-givers.

(In Mandarin): [Please refer to Vernacular Speech.] Now, I would like to talk about how we can improve our care-givers' capabilities.

All care-givers require easy access to information and training to enable them to provide care competently for their loved ones. As far as possible, the Government should simplify these chunks of information and provide them in mother tongues and dialects as well. Many care-givers are themselves elderly and it can be quite confusing for them to process so much information. Having more one-stop information centres at accessible locations islandwide would enable care-givers to obtain reliable and updated information more easily – not all of them are computer literate nor comfortable getting information online. We can also draw upon community resources such as volunteers from neighbourhood groups who can be trained to disseminate information and translation to support the one-stop centres. These volunteers can also be part of care-givers support groups which they came turn to for social and emotional support.

Training should be accessible from multiple sources. Whether online or classroom training, sessions should be conducted in multiple languages so that everyone, including Foreign Domestic Workers (FDW), would be able to understand easily and learn in bite-size modules to accommodate different schedules.

(In English): In conclusion, Mr Speaker, caring for a senior is a whole of society effort. Now is a timely opportunity for the Government, for our community and for individuals to come together and study ways to improve support for our care-givers and help our fellow Singaporeans age with dignity. Sir, I beg to move.

Question proposed.

Mr Speaker: In accordance with the decision of this House to have a simultaneous debate on both Motions, I would now call the Members to make their speeches. So, Members are allowed to consider both Motions in a single speech.

12.42 pm

Dr Lily Neo (Jalan Besar): Mr Speaker, Sir, I stand to speak in support for both Motions raised by Mr Henry Kwek and Dr Chia Shi-Lu. Sir, on my maiden speech in Parliament in 1997, I spoke on my foremost concern and that was the topic on the best ways forward to cope and plan for the seniors in an ageing population. I spoke on the need to plan in advance and better prepare in the provision on healthcare needs and social needs. Today, 22 years later, this topic is still relevant with increasing pertinence. And I am glad that many Members of this House are speaking up on this area and in support of it.

I have been an advocate on the promotion of quality life for seniors all these years as the main basis of the best way forward for successful ageing in our population. The aim is for seniors to live healthily and happily with good physical, mental and social well-being, for as long as possible, with the promotion of healthy lifestyles. This is the reason for the four Senior Activity Centres in Kreta Ayer-Kim Seng Constituency for the last 20 years.

The other aim is delaying and limiting the disabilities in the seniors, by preventing diseases and detecting diseases early and treating them early, to prevent complications of diseases.

Our Government had acknowledged the importance of healthy living for a happy populace, through the promotion of healthy lifestyles, to be adopted by seniors. Thus, the island-wide community Active Ageing, under PA's Wellness Programme for seniors, is now adopted by almost all RCs. In the area of preventing disabilities, MOH had also emphasised on the prevention of chronic diseases, an example of which is the recent campaign on "war on diabetes".

Hopefully, with preventive healthcare approaches as above, we can keep seniors as healthy and happy and reducing disability for as long as possible. But inevitably, many if not all seniors will become frail especially towards the end of their lives. Hopefully, the frailty stages can be minimised.

In 2010, there were about 31,000 individuals that needed help with one or more Activity of Daily Living (ADL). These ADLs are dressing, eating, toileting, transferring and continence. About 7% of the population or about 83,000 individuals in 2030 will have deficit in one or more ADL. This is about two-and-a-half times today.

Today, I want to focus my speech on seniors who require assistance in their daily living due to frailty or disability. They need special attention and assistance. These seniors need care-givers to enable them to live with dignity. With Singapore’s demographic profile, especially going forward, many people are required to provide these caring roles for dependent seniors.

The report on the survey of Informal Care-giving in Singapore showed that in 2010, 8.1% of Singapore residents aged between 18 to 69 years old, indicated that they provided regular care or assistance to friends or family members. Some 37% of care-givers reported that they had been providing care to their care recipients for over a decade. According to this survey, close to three-quarters of care-givers, or 74%, were in employment.

Surveys in other countries had shown that many care-givers face challenges with financing constrains, with juggling between jobs and their care-giving roles and, in some, with having to look after their young children as well. Many also face physical and mental fatigue.

Care-givers are valued members of any society, they contribute much to their family members, friends and community. Their deeds are commendable and they need to be better acknowledged and supported with better Government policies in place.

I would like to suggest the following, to better enable our dependent seniors to have dignified living, as well as facilitating care-givers to assist seniors to achieve this.

One, financial assistance. To give financial support for dependent seniors will help them cope with daily living and lessen the burdens of their care-givers. Financial support is an important and integral part of help to achieve the desired outcome. I favour the monthly remuneration to these eligible care recipients. This amount should be commensurate with the amount required to pay for a full-time domestic helper to assist with daily activities for dependent seniors.

Presently, IDAPE’s eligibility is stringent with three ADL deficits requirement and the amount of about $150 to $250 per month on a means test basis is insufficient. ElderShield's criteria are just as stringent with three ADL deficits before being eligible. The amount claimable of $300 to $400 for limited years is not sufficient for long-term care, as disability and frailty of seniors are usually not reversible. Many seniors are also not on ElderShield and the new CareShield's premiums are out of reach for most seniors. I, therefore, urge our Government to better provide our seniors with better financing grant. I hope the existing grants will not be removed even with any new grants.

Two, facilitating seniors to age in place in the community. Many seniors have expressed that they prefer to live for as long as possible in their own homes, in the familiar environment and in the community with old friends. Many do value the joy of living with their family members. We should have policies to enable this. We should also encourage the community to come together to make this work.

Kreta Ayer-Kim Seng constituency has such a grounds-up grassroots and community initiative. It is called AGH or Ageing Gracefully at Home. This was set up in 2014 in the Chin Swee HDB rental blocks and now also extended to the Kreta Ayer HDB rental blocks. AGH is a holistic care programme carried out by half a dozen full-time care-givers that include nurses for the frail seniors with mobility disability living alone at the rental blocks. These disabled seniors do not have family care-givers and cannot afford domestic helpers. Under AGH, home visits are provided for these frail seniors with the following services, daily supervision on meals, blood pressure checks, medicine intake, home cleaning services, bathing, identifying people who are sick, medical assistance, hospital transportation and so on. Able-bodied residents of the blocks are remunerated in kind to provide befriending services to those disabled residents. VWOs are roped in to provide the assistance to the seniors to fill the gaps.

Presently, AGH is looking after about 500 dependent care recipients in these two precincts with 1,155 rental flats. Since its inception, I noticed that more seniors could remain in their own rental homes. There were lesser fatalities in these homes with lesser admissions to hospitals. More importantly, residents are happier living and ageing gracefully in their own homes with AGH assisted programmes. Agency for Integrated Care (AIC) is now supporting this programme. I hope the Government can look into similar models to benefit more seniors in other precincts. I also hope that care-giver support grant which I proposed earlier, can be extended to the community care-givers such as AGH, to look after seniors with needs better.

Sir, I have spoken many times in this House to develop our homecare, as an integral part of healthcare in an ageing population. The purpose of homecare is to enable seniors with medical conditions to remain in their own homes; this is especially useful after discharge from hospitals. Homecare in Singapore is at its infancy. Under homecare, MOH can facilitate services such as medical care-giving, nursing, medication, nutrition, occupational therapy, rehabilitation therapy and other domiciliary services in seniors’ homes.

May I request MOH to dispense mobility aids, such as wheelchairs, walking aids, joint braces and so on, tailored to the needs of patients and using Seniors’ Mobility and Enabling Fund (SMF), before sending seniors home at hospital discharge? This is a better step down care approach, which will improve outcome of residents coping at home.

Many family members, usually care-givers themselves, have told me that they were apprehensive and concerned that they would not be able to cope with their family members who are just-discharged from hospitals. To better equip care-givers, it is thus good practice to ensure family members get the information and support they need at this early stage, before discharging patients to their own homes, and to hold care-givers’ hands in managing their care recipients at their own homes subsequently.

Three, better support for the care-givers. Many employed care-givers have expressed difficulty balancing between holding demanding jobs with their care-giving roles. Will our Government consider requiring employers to grant paid "Care Leave" to their staff who are care-givers? By so doing, Government will send the right message, in an ageing population, on the importance of empathy, for the caring roles of care-givers. Such paid "Care Leave" can be two weeks, for a start, similar to "Parental Leave".

Flexible work arrangements should be encouraged and incentivised in our workforce. Government Ministries should take the lead to implement it. This will improve care-givers' employability with less frequent absenteeism and lack of concentration at work.

Care-givers can suffer burnt-out syndrome from emotional and physical fatigue. Respite care can be further made more readily available for care-givers, to better perform their roles. Social Service Office (SSO) should be the one stop center for information and respite care referrals for care-givers. AIC can station their staff at SSO to provide this role.

The pricing for respite care services can be daunting for those without subsidy. Prices can range from $100 to $125 per day. A family with an average income of $5,000 may have to fork out almost $1,000 for one-week respite care.

Many care-givers are interested to take up courses to better equip themselves for their roles. Many care-givers also get domestic helpers to assist them with their care-giving roles. But the Care-givers Training Grant annual subsidy is only $200 for each care recipient. If multiple care-givers of the same care recipient wish to attend the training, the $200 would need to be shared amongst them. Most home training courses cost $200 for the basic two-hour training. I hope MOH can make care-giving training more accessible and affordable.

Lastly, independent living for seniors. Majority of people aspire to continue to live in their own homes as they age. Housing adaptability to accommodate seniors’ mobility as they progress in years, as well as having seniors’ friendly environment in the vicinity, will enable them to live their normal lives, for as long as possible, without having to rely on others. Examples of housing adaptability are installation of ramps and grab-bars, having space and doors for motorised mobility aids, non-slip bathrooms, appropriate-height kitchen table tops, hoisting aids to get out of beds, emergency call points and so on. Technology adaptability such as smart home aids for seniors, fall sensors, emergency medical detection sensors and so on should be used to enhance quality of life.

Friendly environment in the vicinity of seniors’ homes should have food centres, health facility, and wellness centers with barrier free access to these places. Every few blocks should have at least one Senior Activity Centre to promote physical, mental and social wellness of the seniors. I urge our Government to build new homes at the outset of public housing construction, to be “future-proofed” for the consideration of independent living, for seniors.

Mr Speaker, Sir, as we strive to be an inclusive nation, let us endeavor to ensure that our seniors, after contributing in their younger days, will age with dignity in their retiring years, as valued members of our society.

12.58 pm

Mr Chen Show Mao (Aljunied): Sir, every two years, I make a speech in this House about supporting our care-givers, like many other Members do. Three speeches ago, I said that "it is not so much what is said, but what is done, that will be the measure of our progress." Together with others in this House, I look forward to the Government’s continuing efforts to lend support to our care-givers.

There are different types of care-givers: some are paid for their care-giving, others are not: we call them informal care-givers. They take care of family members or relatives who are young, who are disabled or who are seniors. Today, I talk about informal care-givers who take care of seniors.

In many ways, informal or unpaid care-givers enable other Singaporeans to carry out the economic activities that are counted in our GDP, while their own care-giving is not. As of now, the burden of informal care-giving falls disproportionately on women. Our dependence on this group of Singaporeans is real, is substantial and is very often unacknowledged.

It is well‐documented that care-givers often suffer declines in their own financial circumstances, and mental and physical health. If they also work full time or part time at a paying job, their performance suffers. We understand that the Government is prepared to study the feasibility of eldercare leave to help working informal care-givers also take care of seniors at home, as childcare leave helps working mothers. This would be welcome.

But, Sir, almost half of our informal care-givers to seniors do not work at other jobs, often precisely because of the unpaid care-giving responsibilities that they have taken on, to their financial detriment and reduced retirement adequacy. We understand that the Government is reviewing enhancing care-giver support in areas, such as respite services and working with community partners, to offer more socio-emotional support to care-givers. Would the Government also consider socio-economic support, such as CPF top-ups for full-time informal care-givers in low-income households, to reduce the pressure of being unemployed or under-employed and unprepared or under-prepared for retirement or for old age as a result of taking on the responsibilities of caring for their loved seniors?

(In Mandarin): [Please refer to Vernacular Speech.] Mr Speaker, Sir, "When the Great Way prevails, public society is shared equally by the people." In the society of "Great Harmony, the aged is provided for till their end, the able-bodied find employment, the young are nurtured, and the widowed and the disabled are cared for." Well, in our society, the burden of looking after the old, the young and the disabled falls mainly on female members of the family. Often, they themselves are old, and look after an even older member of the family. Influenced by traditional gender stereotypes, the spouse and the unmarried grown-up daughter are often seen as natural candidates as care-givers to seniors, with their own needs often neglected.

While their care-giving is not included in economic data – not counted in the GDP– it brings real stress and burden that can lead to limited social life, stunted personal development, including career development, as well as declines in physical and mental health. These so-called "informal" care-givers are often forced to take up low-paying jobs with flexible hours and terms, or to leave the labour force altogether, thereby aggravating their low economic status in the family, and loss of opportunities to increase their CPF savings to meet future needs.

I understand that the Government is prepared to study the feasibility of eldercare leave to help working informal care-givers also take care of seniors at home, like childcare leave helps working mothers. As for non-working informal care-givers who stay at home full-time to look after the elderly, especially those from low-income families, I hope the Government will consider CPF top-ups and other means to provide them with financial support. Thank you.

1.03 pm

Mr Christopher de Souza (Holland-Bukit Timah): Sir, I stand in support of Dr Chia Shi-Lu's Motion and Mr Henry Kwek's Motion. They are excellent initiatives and are timely. Even as it is important to show support to our elderly in their golden years, it is equally important to care for the care-givers themselves because care-giving, though meaningful, can be extremely challenging and demanding on time, energy, emotion. Therefore, we need to support care-givers both to give them the much-needed respite as well as financial help.

In the constituency I serve, we see care-givers who are not working but are caring for their aged parents full-time. In the workplace, we see people who work during the day and return at home to give care to their parents who are aged.

To provide respite for the care-givers, there needs to be people who can stand in to care for the elderly while the primary care-giver is taking a much-needed respite to rest and be recharged. Besides training courses that are geared towards equipping primary care-givers with the necessary skills, what is also important is training courses for others to learn the skills. This would allow others to provide flexible home-based care so that primary care-givers can enjoy the weekly respite they need.

Another important way in which care-givers can be supported is through care-giver leave and flexible work arrangements. This will help those who feel the need to accompany their aged parents for medical check-ups. Other times, when an aged parent unexpectedly falls ill, such measures will allow care-givers to have the peace of mind in knowing that they will have the ability to address emergencies on the home front.

To support care-givers financially, there can be greater subsidies or Government contributions for home-based care assistants working in Voluntary Welfare Organisations. This is important so that our seniors can choose to age well at home – in an environment that is conducive, comfortable and convenient.

Another way in which we should support care-givers is to consider seriously the provision of a care-giver allowance. This is to recognise the sacrifices made by primary care-givers as well as the crucial contributions they make.

Tax reliefs are useful. However, not all care-givers may work. Lower levies do not benefit those who may not be able to afford foreign domestic workers. Institutional subsidies are unable to support those who are cared for at home. So, these Motions are timely to help address some of these gaps.

Because of the wide variety of ways in which care is provided, care-giver allowance should be provided so as to meaningfully benefit those who would otherwise not enjoy financial help rendered. This is in line with the reason cited in the ElderShield Review Committee Report as to why cash reimbursements should be provided so that it will provide claimants and their care-givers the flexibility to decide on their desired care arrangements.

Any financial help for the person being cared for will, in turn, benefit the care-giver, whether the care-giver is a family member or a person who is paid. If the care-giver is a family member, the financial relief can be used in ways which would otherwise be used to provide care for the person cared for. If the care-giver is a person being paid, that care-giver can be paid better. Providing care-giver allowance will also be a key step that the Government can take to lead the paradigm shift in the perceptions surrounding the vocation of care-giving.

But this is not just a call for practical action, but also a principled statement. A statement that we need to care for all – the young, the middle-aged, the elderly. Why? Because we believe that every person is precious no matter what their age. Everyone should be able to age with dignity. Just because a person is not working or unable to take care of themselves or may not be mentally alert does not mean that the person is not valued in society. No. This is not the Singapore way. In Singapore, we respect our elders. That is why we want to create more policy space so that our elderly can age with dignity, financially supporting them and their care-givers. Again, this brings home the point about why both the Motions today are timely.

We should not in any way regard the elderly as a burden. I hope that this Motion will give the elderly the message that they are respected and looked up to. The elderly has a special place in the community and we have a lot to learn from them. This is the reason why, in my constituency, we have situated an infant care centre, childcare centre as well as a senior care centre near each other. We are planning various initiatives for both groups of people – the children with their parents and the seniors with their care-givers – to interact meaningfully with each other, for example, having combined celebrations of the different festivities, interactions during the year-end childcare celebrations as well as introducing grandparents' week. What we want is for them to have fruitful interactions with each other to strengthen the imparting of good moral values, such as kindness, caring and respect. So, what we are debating in Parliament today is a reflection of the high position we give the elderly in our community.

Furthermore, I think that this is a good first step to recognising the valuable contributions and unique challenges that care-givers face. I feel that we can and should look beyond care-givers of the elderly. In my constituency, I have witnessed the great courage of parents and family members of those who are physically or mentally challenged. They have a great weight on their shoulders. Sometimes, unfortunately, the father leaves and the care-giving duties fall fully on the mother.

For those who care for these children with special needs, much care is taken to create a protective environment in the home for the child. But what that means is that there is very little downtime for the care-givers themselves. Care-giving is a 24/7 job, except when the person cared for is sleeping, which is when the care-givers sleep, too. They, too, need to be able to rest and recharge emotionally, physically, mentally. But often, there is no opportunity for the much-needed respite.

Allow me to give a real example. A single mother in Ulu Pandan, the constituency I serve, takes care of her special needs child. We were in contact for a number of years, partnering her family and supporting them. One day, she shared with me that she has another child, a daughter, who was getting married and asked whether we would be able to arrange care for her teenage son with special needs so she can attend her daughter's wedding. As there was no one who could help care for her son during that time and her son needed specialised, close supervision, she was prepared not to attend her daughter’s wedding.

That struck me – the level of commitment and dedication of that mother. Because her son had a tendency to harm himself, we made special arrangements with a hospital to care for him for those two days on which the wedding took place. After the wedding, she continued to take care of her son at home. She recently broke the happy news to me that she is now a grandmother – her daughter gave birth. What a remarkable mother and grandmother.

It brings home, Mr Speaker, the importance of what we are debating through the two Private Members' Motions today in Parliament.

Therefore, what I am asking for is that the support for care-givers be extended to care-givers of those who are physically or mentally disabled or mentally challenged. These Motions are a stepping stone. But, surely, we can and should move beyond the elderly.

Nevertheless, it is not my purpose to distract from the good starting block that we are at now, in particular, caring for the care-giver of the elderly. The community needs to support ageing with dignity.

When it comes to caring for care-givers, some care-givers are themselves in a vulnerable position. While some care-givers may be married and have a reservoir of extended family who can come in at least once in a while and support, others who did not get married may not have such resources available. They may be singlehandedly fulfilling care-giving duties, juggling between work during the day and caring for their aged parents at night. Others may themselves be retired. It is especially important to help care-givers who are themselves in a vulnerable position.

I am confident that MOH, MSF and the Government will put in place measures that will benefit and provide the much-needed support for our seniors – our seniors who helped to build the Singapore we have today to age with dignity, and to provide their care-givers with key support mechanisms. Therefore, I support the Motions.

1.14 pm

Ms Joan Pereira (Tanjong Pagar): Mr Speaker, I rise in support of both Motions. The Motion on "Ageing with Purpose" is a follow-up on the position paper "Empowering Us to Live with Purpose and Dignity in Our Senior Years" submitted by the PAP Seniors Group. I would like to begin by expressing my sincere thanks and appreciation to each and every one who had contributed to this PAP.SG initiative.

Under Speaker Tan’s guidance, my parliamentary colleague Mr Henry Kwek and I completed this position paper with the support and feedback of seniors from all walks of life and experts in healthcare and ageing. With longer life expectancies, many of our seniors and, in the near future, we ourselves will be looking at a much longer period of our lives spent in old age. To age with purpose and dignity, we must be able to spend our senior years meaningfully.

It is estimated that a quarter of Singaporeans – 900,000 – will be seniors in a decade. There will be physiological changes and, hence, adjustments to policies and infrastructure are necessary. We require repurposing, from providing smaller assisted-living (AL) flats with shorter leases to programming longer "green man" time for crossing roads. Active ageing requires support from both the Government and society.

I would like to start with homes. For many seniors, it is important for them to keep their independence and to age in place. We will need to provide more Assisted Living options in both HDB and private housing.

We would like to appeal for senior Group Homes with Assisted Living facilities within HDB estates. We can either utilise available void deck space, where suitable, or transform several combined HDB flats into a senior Group Home with AL facilities. Like The Henderson Home in Henderson-Dawson ward where I serve, the flats and a senior activity centre are served by staff members on call and a resident carer. We hope that Kampung Admiralty’s concept of locating senior housing together with medical facilities, transportation, shopping and other amenities can be duplicated in new estates and on available land in older ones.

Next, I would like to suggest that we build more Senior Activity Centres (SAC) at locations within walking distance of seniors’ flats and apartments. This concept would be similar to the Wellness Kampungs where seniors can do exercises and take part in various activities, such as digital literacy, while at the centre, and senior volunteers may step forward to help if they wish. Exercising in a group will provide the motivation for our elders to keep up with their friends’ and neighbours' fitness levels.

On the other hand, digital tools will increasingly dominate almost every aspect of our lives. We, therefore, wish to see better programmes aimed at helping seniors to improve their digital literacy, in ways which can help to value-add to and improve their quality of life. We must not leave anyone behind in moving forward as a smart nation and should provide more support to help our seniors go digital.

With increasing number of seniors, we need to boost SAC’s or Wellness Kampungs' capacity in both HDB and private estates. Having such centres near to their residences will encourage our elderly to take part in the activities there more frequently. The proximity will allow seniors to easily walk home and rest without worrying about transportation. Their families will also have peace of mind knowing that there will be someone keeping an eye on their parents, and even grandparents.

We are advocating for a "many helping hands approach" to help us Singaporeans age well. And the most important pair of hands belongs to one's family. Our family sizes are shrinking due to a falling birth rate, and this means that there are fewer "hands" around who are considered immediate family members. How about helping hands from extended family members?

Therefore, we are proposing a broadening of the definition of family members in government policies to better allow Singaporeans to help support their extended family members if they wish. The key word here is choice. If the extended family wishes to help, our policies should encourage it. Take CPF, for example. We would like to suggest that extended members of a family be allowed to contribute to one another's account, for example, from grandchildren to grandparents, if they wish. Sir, in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] We are advocating for a "many helping hands approach" to help us Singaporeans age well. And the most important pair of hands belongs to one's family. Our family sizes are shrinking due to a falling birth rate, and this means that there are fewer "hands" around who are considered immediate family members. How about helping hands from extended family members?

Therefore, we are proposing to broaden the definition of family members in Government policies to better allow Singaporeans to help support their extended family members if they wish. The key word here is choice. If the extended family member wishes to help, our policies should encourage it. Take CPF for example. We would like to suggest that extended members of a family be allowed to contribute to one another’s account, for example, from grandchildren to grandparents.

(In English): Another area is care-giving. Familial ties run deep in our society, even amongst extended family members. We should recognise and support the efforts of care-givers who can be part of the extended family. Such forms of support can also help to reduce the number of isolated elderly in our midst, given that there are isolated elderly who do not have children but may still have extended family members who can and wish to help out.

Care-giving is performed with love and warmth but it is also one of the most physically and emotionally draining tasks on earth. Family care-givers are seldom compensated financially for their effort and time and out-of-pocket expenses can lead to financial hardship for lower income care-givers. We would like to propose that the Government consider supporting family or informal care-givers with an allowance, particularly full-time care-givers taking care of elderly with disabilities or mental health problems. For part-time care-givers who work, we appeal for more employers to offer flexible working arrangements (FWA) so that they can retain talented and experienced staff who make valuable contributions to their companies and our economy. We should also support our care-givers by forming a network of support and guiding them in the navigation of social space so as to better look after their loved ones and themselves.

Next, on volunteerism, a topic very close to my heart. Volunteering is one of the key hallmarks of active ageing. Elderly volunteerism or senior volunteerism will allow our elderly to stay active and engaged in the community. The regular interaction also enables them to look out for one another, make new friends and strengthen kinship amongst neighbours. We believe volunteering will lead to well-being and good health for our seniors.

Our seniors' wisdom, talent, wealth of experience and strong moral values make them very suitable for volunteering. They are generally more patient and, hence, suitable as mentors to younger volunteers. I am particularly keen for such inter-generational volunteering efforts to succeed as we should encourage and strengthen bonding between the young and old.

I hope that our community can actively reach out to our seniors when recruiting volunteers. We all have our passions and calling and, given the chance to volunteer in our areas of interest, we will gladly bring our expertise and knowledge to serve. I know of a resident in her 70s, Lucy is her name, who initiated a neighbourhood citizen patrol group because she was worried about the safety within her estate. Whether it is a hospital, museum or school, I hope our public, private and charity organisations can keep a special lookout for the "silver pool" as a volunteer resource. Whenever possible, consider making modifications to programmes to enable our seniors to join in or even better, tap upon their talent, wisdom, rich experience and abilities.

We want to have many helping hands in supporting ageing, with the family as the core, and the Government as well as other organisations in the community coming together to support our seniors. I would like to conclude with my support for both Motions.

1.25 pm

Ms Rahayu Mahzam (Jurong): I would like to share some perspectives on three areas relating to ageing – employment, living environment and healthcare costs.

Firstly, in respect of employment. I trust many of us, as Members of Parliament, would have received requests for assistance from seniors regarding their employment. Many of my older residents who have come to see me shared their challenges either in staying employed or finding a new job. Some need to stay employed as they still need to pay for their living expenses. Some want to remain active and engaged. Many are usually still capable of working, have a wealth of knowledge and experience and can still contribute to various industries.

I believe at times, there are mismatched expectations. I have heard feedback from some employers who have concerns about hiring seniors. It may be less cost effective to employ an older worker who expects the same amount of pay that he or she is used to but may not be able to accept a bigger scope of work. The inherent assumption is that a younger employee who is hungry for a challenge may be less demanding and be willing to put in extra hours, for less pay. Further, there may be difficulties promoting and advancing the careers of younger employees if the older workers do not "make space".

In this regard, the Government’s efforts in introducing various policies and schemes over the past decade have helped. The WorkPro Job Redesign Grant and Age Management Grant, the Special Employment Credit and Additional Special Employment Credit and the Workfare Income Supplement have helped to alleviate some challenges the elderly face at work.

I acknowledge that without all these policies and schemes, the employment situation for the elderly workers may be more challenging. I believe though that as a community, we can and must continue to work towards combating any discrimination against older workers and create an even more conducive job market for them.

There is a need to continue to support and encourage employers to see the benefits of employing older workers and guide them towards redesigning jobs and creating work arrangements that could be a win-win for all. There may be a need for a little handholding and a deeper understanding of the demands of the specific sectors. I therefore propose a sector-based approach with consultancy services where employers can be guided towards redesigning or creating suitable jobs for seniors that would benefit the business and the industry.

The Government could work with unions, grassroots leaders or other industry stakeholders to create support platforms that would help push and further encourage the adoption of existing grants and schemes so that more seniors can be employed. These platforms could also incorporate opportunities for open discussions with older workers about the needs of the industry or sector so that we could also work towards shifting mindsets of older workers and manage their expectations. I believe with a little more effort and support, we can change the current job landscape for our older workers.

The second point I would like to touch on is the living environment for the elderly. In this regard, it is noted that the approach taken with the Kampung Admiralty development is very commendable. Moving forward, we would also have to consider the fact that the elderly group is quite diverse and may have different needs and preferences, depending on their family make-up and their financial situation.

To ensure that Singaporeans, now and in the future, are able to age with purpose and dignity, I believe we should look at ensuring that there would be options for different living arrangements. One option is group homes or retirement homes with assisted living facilities, something mentioned by my colleague, Ms Joan Pereira, earlier. I believe this is where we can take a whole of community approach and encourage developers from the private sector to step up.

I note that there was an attempt at this model with one of the developments at Jalan Jurong Kechil, which is in my estate. The development was slated to be a potential retirement village. The idea was noble but, now that it is developed, many have questioned whether it is just a typical condominium as there were no real guidelines on who the units were sold to. We may want to revisit and refine this model.

MND or HDB and MOH could support these efforts by revising guidelines to enable and promote the setting up of group homes or retirement homes with assisted living facilities in the private sector. This could mean creating a new strata title category and legislation which could ring-fence non-seniors from purchasing such properties and deal with the conversion or transfer of ownership upon demise of the owners.

On a related point, MND or HDB and MOH may want to consider doing a trial of the group homes for frail seniors in the public housing estates. This could mean, as Ms Joan Pereira mentioned, converting several HDB units to form a group home with assisted living facilities. This may be one way where the seniors could stay within familiar areas and be close to their families.

The other aspect of the living environment is the design of common spaces. Once my grassroots leader told me that he overheard two elderly ladies talking after an event. One of them was looking for a toilet and the other one said, "See, I told you to wear a diaper. My children bought me a few packs and I am using them. It’s so convenient". It is clearly a personal choice. On one hand, I was amused and heartened by the lady's candour and outlook on life. She did not let her situation get in the way of her being active.

The point is though, there are some physical challenges when one gets older – challenges that robs you of your dignity, your enthusiasm, your interest in participating in activities. It is thus important that we continue to ensure that our living environment is made suitable to alleviate some of these challenges. The proposal is, therefore, for the agencies to continue to look at the design of common spaces and take into account the challenges of the ageing population. For example, the agencies could ensure that there are more toilets and benches in parks, near senior fitness corners or other common spaces so that we can improve the living environment for the elderly and encourage them to keep active.

I move to my third point on healthcare costs. I would like to specifically touch on the Community Health Assist Scheme (CHAS). In a previous speech earlier last year, I had shared about the frequent appeals I have seen, for an upgrade to the blue CHAS card and called for a review of this scheme. I am happy that at the National Day Rally last year, Prime Minister announced that the scheme would be extended to all Singaporeans with chronic ailments regardless of their income. This is indeed a welcome move. I appreciate that much funds have been poured into this scheme. I would have to though, reflect the sentiments on the ground of the concerns regarding the regular medical costs that elderly residents have to incur. The CHAS cards are very precious and meaningful for the seniors and the scheme goes a long way in helping them with their expenses, especially for those who have to seek regular medical treatment. I would, therefore, request that some adjustments be made, for example to raise the income ceiling so that more elderly residents would qualify for CHAS or to increase the subsidies available within the scheme.

Mr Speaker, I would like to touch on another challenge in relation to ageing; that is care-giving. I fully support the call to the Government and the community to continue strengthening the support for care-givers. In this regard, I would like to highlight the struggles of the sandwiched class, who have to take care of both their elderly parents and their young children. Often in these families, the husband and wife are working and they rely on the foreign domestic workers (FDW) and childcare services. I acknowledge and welcome the support for these families like the working mother subsidies and relief and the FDW levy concessions.

The daily routine can already be rather draining; especially if the elderly need regular medical attention. It gets more challenging when what I call the “expected unexpected event” takes place. A child falls sick, the helper decides to go home, a sudden project needs to be attended to at work. At times, all that can go wrong, go wrong at the same time. And this can happen fairly regularly.

At this juncture, I would like to add that although the focus of this motion is on the needs of the care-givers of the elderly, I hope that attention is also given to care-givers with children with special needs or persons with disabilities. As a parent of a child with special needs, I can empathise with the challenges. These challenges are compounded in certain circumstances. For example, I have several residents who have more than one child with special needs. I know one parent who has three children with special needs. She is a single mother and needs to work to sustain the family. She has two helpers out of necessity. She is not wealthy but appears to be managing well. But sometimes, things get challenging. One time there was a change of helper and the new one was not able to handle her disabled children. It was tough for her to manage work and the household during that period.

It is not easy to come up with a complete solution to support care-givers but I think one aspect we could look at is how we can work with employers to encourage flexible work arrangements in the office. I appreciate that there are existing grants available but, perhaps, a more targeted push could be made to increase the adoption of the grant.

I would also ask for greater flexibility and compassion in assessing eligibility for various schemes. There are understandably criteria and rules in place to regulate the assessment. However, there may be situations where we need to exercise more discretion. Recently, a resident sought assistance to be eligible for the Senior Priority Scheme in her application for a 2-room flexi flat. She was eligible initially but had subsequently sold her flat as she was caring for her elderly mother and needed to liquidate some of her assets to pay for their expenses. She could not work as she was caring for her mother full-time. She failed to note that selling her flat would make her lose her priority. Her mother subsequently passed away and now she is hoping to stay in the same area as her sisters live there too. The chances of this happening is now much lower. This may be a situation where some discretion could be exercised. I appreciate that agencies do exercise discretion at times and accede to requests in various circumstances and I hope that this approach is maintained and enhanced. Mr Speaker, in Malay please.

(In Malay): [Please refer to Vernacular Speech.] Today, we are debating two Motions that call for a whole of Singapore effort to ensure that Singaporeans are able to age with purpose and dignity, and also to ensure support for care-givers is strengthened. When we speak of care-givers, I feel that it is important to ensure that any assistance rendered should also include care-givers to children and disabled adults.

A host of challenges will certainly begin to occur when one reaches his or her golden years. We have seen the advent of issues related to employment, housing, medical costs as well care-giving. The Government is aware of this situation and has already taken steps by implementing certain schemes like the WorkPro Job Redesign Grant, Special Employment Credit and CHAS, that can help overcome several aspects of the challenges faced by seniors. At the same time, assistance is also available to provide some kind of support to care-givers, like FDW levy concessions and the Work-Life Grant.

However, in order to ensure the effectiveness of all available schemes, we must constantly review the assistance rendered and continue to work with all stakeholders, for instance, employers, in order to keep on enhancing the support provided. I am confident, with the combined efforts of Government and Singaporeans, a comprehensive social support network can be created.

(In English): I think there are many good policies in place to help support ageing with purpose and dignity and in providing support for care-givers. It is time though that we take a whole of Singapore, a whole of community approach to help ensure the implementation of such policies addresses the needs of those they are meant for and that the gaps are plugged. I stand in support of the two Motions.

1.38 pm

Mr Muhamad Faisal Bin Abdul Manap (Aljunied): Sir, I would speak in Malay.

(In Malay): [Please refer to Vernacular Speech.] Sir, I would like to speak on three matters. First, I would like to request for the latest updates on Singapore's efforts to achieve the vision of "Successful Ageing for Singapore". Second, I would like to ask the Ministry of Social and Family Development to conduct a study on issues related to our senior citizens, and third matter is related to care-givers for the elderly.

In managing ageing issues, an Inter-Ministerial Committee for Ageing was established in 1998. The main task of this committee is to achieve a vision, that is, "Successful Ageing for Singapore".

The first report of this committee was published the following year in 1999. This report covered various aspects of living that required transformation, enhancement and renewal in order to achieve "Successful Ageing for Singapore". These aspects of living were divided into three categories. The first one is Heartware, which refers to the values, attributes and perceptions of the individual and society towards ageing and the elderly. Second, Software, which encompasses national policies, plans and services that will provide opportunities and chances for our seniors to share and contribute their energy, experience and wisdom. The third one is Hardware, that provides public infrastructure and facilities that are elderly-friendly so that it will be easier for them to interact and integrate with society.

These three aspects, Heartware, Software and Hardware, are essential in the effort to achieve Successful Ageing for Singapore. To me, however, Sir, Heartware which refers to society's values and attributes, is the main driver in shaping and creating a society that is highly concerned towards ageing issues. With the correct values and attributes, every individual will be involved sincerely and contribute as much as they can to make a concerted effort to achieve the vision that has been established. However, the process to transform values and attributes is admittedly not an easy one, as it takes time and requires continuous effort.

I would like to request that the Inter-Ministerial Committee on Ageing share the latest updates on efforts that have been done, are being done and will be done, especially in shaping Heartware, 20 years after the Inter-Ministerial Committee issued their first report.

Sir, the second matter I’d like to touch on is the people's concern about the issues faced by two groups of senior citizens. The first group comprises seniors who are still doing jobs like cleaning, collecting used utensils at the hawker centres and taking care of trollies. The second group comprises seniors who collect cardboards, aluminium cans and other recycled material that are valuable enough to sell. Sir, it can be said that over the past 10 years, we can see an increase in the number of our seniors who fall under these two groups.

The question playing in everyone’s minds is that, why, at an age where one should enjoy their retirement, there are still seniors like this who still have sweat and toil and work hard.

Do they do this solely because they need to or because they want to? There are many views and perspectives on this issue. Some say that these seniors do so because they require some pocket money, while others opine that it is an activity that fills up spare time and for recreation, and many also are of the view that these seniors do so in order to obtain some income to meet their daily basic needs.

I would like ask the Ministry of Social and Family Development whether the Ministry has ever done any survey to obtain clarity and more precise answers to questions I mentioned above that have become a concern to society with regard to these groups of senior citizens.

Another issue that have often caught the people's attention in relation to our seniors is the issue of suicide. In July 2018, the media reported that the year 2017 saw the highest number of suicide cases amongst the elderly aged 60 years and above, which is 129 cases, ever since such cases were first tracked in 1991. Ms Christine Wong, the Executive Director of the Samaritans of Singapore (SOS), stated that it is worrying that many seniors are turning to suicide as the only way to end their pain and suffering, when they should be enjoying the lustre of their golden years. She also said that, with the increasing number of seniors in Singapore, it can be estimated that suicide cases among this group will continue to increase.

The issues related to seniors that I have shared should be given the fullest attention. I hope that the Inter-Ministerial Committee on Ageing Issues can conduct a more comprehensive survey and study to obtain information and knowledge that will further improve and refine the current efforts so that our vision to achieve "Successful Ageing for Singapore" will become a reality.

Sir, the third and final matter that I wish to highlight concerns the issue of care-givers for seniors. The task of caring for seniors is undeniably a very challenging one especially for those who are taking care of seniors with chronic health conditions, especially those related to ageing like dementia and Alzheimer's Disease. This Chamber have, on several occasions, spoke about ways to provide support for care-givers. Suggestions given include mandating elder-care leave for care-givers who are working. For full-time care-givers, who usually are the senior’s own family members, it was suggested that CPF top-ups be given.

Sir, I would like to give my support to these two suggestions and hope that the Government will fulfil these requests in the near term.

In conclusion, Sir, I support both Motions. Thank you.

1.46 pm

Mr Terence Ho Wee San (Nominated Member): Mr Speaker, Sir, arts for ageing well. It has been heartening to observe agencies from different sectors across Government, arts and cultural companies and enterprises coming together to introduce a variety of arts and culture programmes for senior citizens, allowing our seniors to live a vibrant, meaningful and active life in their golden years. Artistes and arts companies spare no efforts in staging concert and play productions targeting for our seniors. Be it as an audience, volunteer, participant or mentor behind the scenes, our seniors are actively involved in the arts. More can be done to engage our seniors in arts.

The Arts for Ageing Well study in 2016 was commissioned by the National Arts Council (NAC) and conducted by the NTU School of Social Sciences found that participating in the arts or simply attending arts-related events can significantly increase mental and physical health. Three in four seniors surveyed acknowledge the benefits of the arts, and value it as a means of inspiration, expression and bridging differences. The NUS Yong Loo Lin School of Medicine discovered that by participating in the arts and community activities can slow down or even prevent the onset of dementia where after a year of taking part in art, music and social activities, more than 20% of senior citizens surveyed saw an improvement in their memory. They even developed a much more positive outlook in life which acts as a preventive measure against for those who are diagnosed with depression and bipolar disorder.

In relation to the survey, the NAC's signature Silver Arts Festival showcases the meaningful possibilities seniors have in and through the arts in their everyday lives. The annual festival has engaged and attracted close to 40,000 seniors through music, film, theatre and more. NAC has also developed cross-sector partnerships with Social Service Organisations, allowing beneficiaries within the social service sector to have increased access to the arts. This is made possible through initiatives like Art Reach and the WeCare Arts fund, a collaboration between the NAC and People's Association. The fund has benefited more than 171 social service organisations, 91 artists and some 8,300 beneficiaries since 2014. One of the recipients, Sri Warisan Som Said Performing Arts have been working closely with our seniors together with TOUCH Community Services. The outcomes were encouraging and inspiring.

While we engage our seniors in the arts, we must also not forget to pay tribute to our seniors who are involved in the arts themselves, as a mentor, teacher and practitioner artistes. To date, there are 125 Singaporeans and Permanent Residents have been conferred the Cultural Medallion – Singapore's highest accolade in the arts. They have dedicated their lives into the arts, enriching Singapore's cultural landscape. They now guide and nurture our next generation of artists in Singapore.

In addition to the NAC's effort, there are also many national and local arts companies, such as the Esplanade, National Gallery, the Singapore Chinese Orchestra (SCO), Ding Yi Music Company, The Necessary Stage, Drama Box and Nam Hwa Opera, with the support from the corporate enterprises and foundations, who are also engaging our seniors in their own ways with their respective programmes, workshops and initiatives. The therapeutic and intrinsic value the arts has on our seniors is something we have to reflect on, where the involvement of our elderly in the arts would can help them enjoy a better quality of life and to maintain a curious and active mind in their golden years!

I hope that there will be more support and resources catered for our seniors from Government across all sectors, more companies and enterprises, including the people public, bringing and making the arts more accessible for our seniors across society, allowing our seniors to live with dignity, purpose and peace of mind in their golden years, leading a healthy, happy and gracious life.

(In Mandarin): [Please refer to Vernacular Speech.] Arts for aging well. In recent years, various Government agencies, arts and cultural companies and enterprises have come together to introduce a variety of arts and cultural programmes for senior citizens, allowing our seniors to live a vibrant, meaningful and active life in their golden years. Artists and art companies are more willing to stage productions targeting our seniors. So be it as an audience, volunteer or participant, our seniors can play an important role in these arts and the cultural activities.

Studies done by the NTU's School of Social Sciences and the NUS Yong Loo Lin School of Medicine found that participating in the arts or simply attending arts-related events can significantly increase mental and the physical health for the seniors. They can enjoy a higher quality of life and better physical and mental health compared to those not attending any arts and cultural activities. If seniors can actively participate in community or cultural events, their memory can be improved and dementia can be prevented.

The Minister for Culture Community and Youth Ms Grace Fu pointed out at the Silver Arts Seminar on 6 September 2017 that there were many benefits for seniors to participate in arts activities. Three in four seniors surveyed see arts as a channel to know people with different cultural backgrounds. This survey affirmed our efforts to connect communities and encourage people to live a more a meaningful life through arts and cultural activities.

NAC's Silver Arts Festival held every September showcases a series of music, film, theatre events at multiple locations around the island. Many of these events are free so that seniors can develop their arts potential through music, dance and other art forms, and have fun together with their family and friends. The annual festival has attracted and benefited close to 40,000 seniors.

NAC has worked with many organisations such as MOH, AIC, Singapore Mental Health Association and Singapore Dementia Association, to incorporate arts seminars and activities into the social services and health sectors, and to develop more support for arts. NAC will increase art contact points in the community by bringing art performances to nursing homes and the community hospitals. NAC will also train more cultural volunteers to hold arts events for seniors living alone.

The Esplanade held close to 70 performances for seniors between 2017 and 2018, attracting 73,000 senior audience. The flagship event is "Sing Out Loud", aimed to teach seniors with dementia to sing and take part in music activities. By doing this, seniors have one more channel to express themselves and they also have the opportunity to learn different vocal techniques; both their mind and body are being stimulated. Esplanade's Community Care Programme has organised 200 arts events for 6,250 seniors and brought many arts groups and artists to nursing homes, benefiting more than 900 seniors and patients.

The National Gallery and the Deutsche Bank jointly organised the Art Bus Programme to bring 1,782 seniors from 35 welfare homes to the Gallery, so that they have a chance to participate in arts activities and tours. For these seniors, this was their first time in life to step into the National Gallery – the beauty of the facade and the interior of the building has struck them deeply.

SCO, Ding Yi Music Company, The Necessary Stage and the Nam Hwa Opera are doing their part to introduce arts to the seniors. Nam Hwa Opera even brought Chinese opera to the various community hospitals, so that the seniors can watch the Chinese opera at close distance. These arts groups have their own regular workshops and performances to interact and build rapport with seniors. I hope the seniors can enjoy this golden moment of their life by embracing arts and exploring their potentials. Through arts, they can build confidence, become more charming, and reinvent themselves. Here, I would like to commend the 125 Cultural Medallion recipients. They are the maestros in the artistic field and have been contributing passionately to the arts and cultural development in Singapore all their life.

Going forward, I hope the Government can put in more support and resources to develop art activities for seniors, for example, introducing a Cultural Pass to benefit more seniors. We also hope more Government agencies, enterprises and the people’s sector can join the efforts, use art as a tool to bring people joy and exert influence and allow our seniors to live a happy, healthy and a gracious life.

1.57 pm

Ms Tin Pei Ling (MacPherson): Mr Speaker, Sir, I rise to support the Motions. This House has debated and endorsed numerous Motions and Bills in support of an ageing population in Singapore. Just last year, for instance, we debated a Private Member's Motion on support for senior citizens. The importance of addressing the ageing issue in Singapore is clear and cannot be overstated.

Significant progress has also been made with much being done to improve physical infrastructure and social programmes benefiting our seniors by the Government. Government spending has also increased by multiple folds. Public healthcare expenditure, for instance, more than doubled in the past six years.

The Government has implemented comprehensive measures to support the ageing needs of our seniors in Singapore. It is now time to also pay attention to care-givers.

In MacPherson, I have met many care-givers of elderly residents. These care-givers include elderly parents, children who are singles and siblings. It is a common sight that these care-givers give up their jobs and personal pursuits to care for their elderly loved ones. The care demands are high and they are often too absorbed with keeping up with their daily schedules to pay attention to what happens around them.

On Monday, I met a resident Chris at my weekly Meet-the-People Session. He came to seek financial assistance. Chris is in his early 30s and the sole care-giver of his father who suffers dementia and is prone to falls.

Chris' mother passed away years ago after succumbing to cancer and his younger brother cannot be relied on as he had left the family. As a result, Chris had to juggle work in the day and caring for his father at night. As his father is prone to falls, Chris can hardly sleep every night as he stays alert to his father's movements.

He must stay alert all the time; he cannot let up. Chris was visibly burnt out when I saw him, a far cry from how he was years ago before his mother's demise. He is unable to perform at work, unable to get a good pay, unable to pay off his study loans, unable to afford a domestic helper. He is clueless about what he needs to do to care for his father properly and does not know what care options are available to them. I offered some suggestions to Chris and helped him write in to the Agency for Integrated Care (AIC) to seek help.

Chris is perhaps considered to be better off than some of the other care-givers I have met in the community. At least, he still has a job and is young enough to cope with the physical demands of work and of caring for his father. But even so, he is burnt out and needs help.

Care-givers form an important pillar of support in our ageing landscape. They are also critical in delaying potential institutionalisations and enabling our aspirations of helping Singaporeans age in place. Therefore, it is imperative that we strengthen our support to care-givers. Given my observations in the course of my constituency work in MacPherson, I have the following recommendations for the Government.

First, financial support to offset care-giving expenses.

Whilst Chris is still able to fetch an income, many care-givers do not. They gave up jobs to care full-time for their elderly loved ones. If they are fortunate, they may have savings or contributions from married siblings to rely on. But savings can deplete quickly, and regular contributions are not guaranteed. Others may have to apply for public financial assistance to cover basic living expenses. But such financial assistance often does not cover other care-giving expenses. Also, not every household wants to or can hire a foreign domestic helper to care for their elderly, as in the case of Chris. The existing Foreign Domestic Worker Grant will be of little use to them. Hence, providing financial support specifically to offset care-giving expenses, whilst allowing the care recipient or his care-giver the autonomy to decide how to use the money, will be useful in relieving the care burden.

Second, enhance accessibility to care information, schemes and support services.

In my engagements with care-givers, many are often clueless about the types of help available and how to obtain them. Sometimes, they need particular care information or apply for, say, motorised wheelchairs, they imagine themselves having to navigate various Government departments and filling in long questionnaires. This can be daunting. For others who are more digitally savvy and turn to the Internet for information, they dread having to trawl through different websites to piece together the information they need. This can be draining.

Therefore, access to care information, schemes and support services needs to be enhanced. Firstly, provide a one-stop platform where all the information needed can be conveniently and accurately obtained; secondly, bring the platform directly to those who need it. AIC was announced as the one-stop agency for all elderly matter in Singapore. I voiced my support for this last year. But more can be done to exploit its full potential. Despite so much good work done, many of my elderly residents and their care-givers are not aware of the agency and what it is able to offer. Hence, we need to raise the awareness of AIC as the one-stop agency for information and assistance. Beyond this, we should also consider establishing more AIC-satellites within communities, perhaps co-locating them with existing setups such as the Silver Generation Offices, Senior Activity Centres or Community Centres, so that residents can simply walk-in whenever they need help.

Similarly, digital options should also be made available and widely publicised to benefit care-givers who are digitally savvy. An example is to make the Moments of Life app the digital equivalent of AIC.

Third, respite for care-givers beyond conventional working hours. As in the case of Chris, he desperately needs a respite, especially at night when he needs to rest and when his father who has dementia is active. Chris was pale and drifting off at times during our conversation. I was worried and told him that even superheroes need a break. He agreed, but he asked, "Where and how to?” It was a good question. Chris is not alone. I also meet elderly parents who are still struggling to care for their aged children suffering from mental disabilities. They face similar challenges. Not a moment of downtime. Physically washed out, but still pushing on because their love and sense of responsibility are too strong for them to let go. Worse, if the elderly care-giver unexpectedly falls ill, who will take over the care duties under short notice? Therefore, providing respite care beyond the conventional working hours will offer relief and restore balance to the lives of these care-givers.

To be ready for an ageing population and give support to care-givers, relying on the Government alone is not enough. The society too needs to play a more active role. We need a whole-of-society effort. Employers constitute a group of key stakeholders; their compassion and willingness to adapt working arrangements for workers who are care-givers as well are called upon.

In the case of Chris, there is a limit to the number of leave days that he is entitled to. His father is generally fine in the day, as he is still physically fit and has a routine to follow. But there were times when his father was hospitalised due to fall injuries or when he went missing. Chris would have to take leave. Upon utilising all his entitled leave days, Chris could resort to taking unpaid leave, but this is undesired as this affects his income when he is already struggling financially. Also, taking leave reduces his "face time" at work and affects his perceived work performance.

Chris is not alone in facing such a situation. Having sufficient leave days to care for an elderly loved one is much needed, but it is untenable over the longer term. A more sustainable solution is to enable flexible work arrangements so that these care-givers can work offsite and continue to deliver work products while watching over the elderly at home.

Hence, I urge employers to keep an open mind, embrace flexible work arrangements where possible.

So far, we have seen encouraging results in terms of re-employment through the Re-employment Act and hiring of seniors through the Special Employment Credit. To enhance the appeal of implementing flexible work arrangements to employers, the Government could consider increasing financial incentives and mounting a nation-wide campaign to solicit buy-in from employers. In addition, the Government could work with tripartite partners and consider financial incentives to nudge employers to place more weightage on the quality of work output instead during appraisals. Less face time does not mean less commitment to work. Ensuring a fair appraisal will send a positive signal to all employees and enhance manpower retention as well as staff motivation.

As Singaporeans live longer and work longer, we can expect more senior workers who are care-givers as well. Therefore, flexible work arrangement and corresponding adjustments to appraisals to value quality over sheer quantity are increasingly imperative, and I call on employers to work with the Government to implement such arrangements.

So far, efforts have been focused on supporting seniors as care recipients. This is important. It will be very sad if we are unable to take care of our seniors’ basic needs and it will reflect poorly on us as a civilised society.

However, we must be more optimistic and ambitious as well. I made this statement in this House before and I will repeat it – I firmly believe that our seniors are much more capable than being mere recipients of care.

As we enhance our healthcare, we can expect longer and more healthy years. As our economy evolves, there will be less reliance on physical strength at the workplace but more use of intellect and wisdom. As each population becomes better educated and more savvy with the digital space, there will be less fear and deeper entrenchment of technology in our lives.

Some hold the belief that you will get useless when you age, and in Chinese, we call it "老了不中用". While I understand there are some constraints that come with age, I do not agree with this belief. It is self-defeating and we risk a self-fulfilling prophecy. We need to keep active and keep trying. Of course, we hope we do not have to work into our old age because we have to, but I hope we can continue to contribute because we love to. It brings meaning to life, it helps us look forward to every new day with new hope. Is this not wonderful?

Hence, I call on all seniors to maintain a positive outlook and to lead an active lifestyle.

In reality, we know that it takes more than a willing senior to lead a successful active ageing. I made several calls on the Government in this House before to create favourable conditions for our seniors to age actively and gracefully. Allow me to reiterate some of them here.

First, create a favourable environment and employment opportunities for seniors who want to work. Stem out ageism. Government can take the lead in testing how work environment, workflows, job role designs and even compensation and benefits such as health benefits can be optimised for senior workers.

Second, create meaningful volunteering opportunities that play to the strength of our seniors. Incentivise elderly to volunteer more.

I was especially by an example whom this lady called Mdm Anne Choo when I attended the opening of Brahm Centre in December last year. At the centre, we were introduced to Mdm Choo, who, despite being in her late 70s – almost 80, is still very active. She turned from being a volunteer to a staff with the Brahm Centre, and every day she would visit the elderly, some of whom might be younger than her – visiting them, encouraging them, and helping them through with physiotherapy. She is an inspiration and to be honest, after hearing her story, she is my dream, and I hope that one day when I grow old, I can be like her.

Third, design to include. Understand the physical requirements and cognitive characteristics of seniors. Apply elder-friendly designs into our hardware and heartware solutions. We need to mainstream elder-friendly designs and make them pervasive. We need to apply elderly-friendly designs to the development of common spaces, facilities, machine interfaces, workflows, public processes, smart phone applications and more.

Fourth, help seniors to be digitally ready. Equip seniors with the tools and know-how so that they can access the internet and take advantage of useful mobile applications. Help them harness technology to stay connected to news and information, to support networks, to friends and families.

Mr Speaker, Sir, please allow me to continue in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] There is a saying that goes like this, "the young should not mock the old, for there will be a day when he himself will age as well." This is a very interesting statement and I have two interpretations for that.

Firstly, we should actively create an elderly-friendly environment to better look after the elderly, and make sure that their basic needs are taken care of. After all, we will all age one day. If we do not respect and take care of the elderly today, who will respect and take care of us when we get old?

Secondly, we need to look at the retirement life with a positive attitude. Being old does not mean that one is useless and will be detested. Just like sunset, the elderly too can cast a beautiful glow in their old age.

Population ageing in Singapore is a familiar topic to us. For years, the Government has been making tremendous efforts to tackle the challenges brought forth by ageing, and seek ways to better take care of the elderly. The result is clear to all, especially when it comes to elderly welfare which has been put in place gradually .

But at the same time, as we tackle the challenges brought forth by ageing and strive to fulfil the vision of ageing in place, we cannot neglect the important role played by care-givers. We need to take care of their welfare as well and give them practical support. In community service, we often see that many of these care-givers are actually family members of the elderly. They take pains to take care of the elderly, some even give up their careers and dreams. In this process, they will encounter many difficulties and need assistance.

As such, I hope that the Government can be more proactive and provide more comprehensive support to the care-givers. I have four recommendations.

One, subsidise the expenses needed to take care of the elderly to help relieve their financial burden.

Two, consolidate information related to caring for the aged, put them up proactively in the community so that care-givers can get needed help in time.

Thirdly, provide respite services outside normal working hours so that care-givers of dementia patients can get enough rest and enjoy some work-life balance.

Fourth, encourage the employers to adopt flexible work arrangements so that employees who are care-givers can attend to family emergencies while still being able to complete their work. To implement flexible work arrangements, the performance appraisal system should also be tweaked to pay more attention to quality of work. This is not only fairer, but also more humane. To the employees, it is also a form of encouragement.

Lastly, I would like to encourage everyone to support active ageing. We should not have this negative mindset that "being old is useless", because the elderly can also lead a vibrant life, like a beautiful sunset. Even in our twilight years, we can still strive to broaden our horizons, keep up with new trends, continue to learn, enjoy ourselves and contribute to the society. Thank you.

2.14 pm

Mr Melvin Yong Yik Chye (Tanjong Pagar): Mr Speaker, I stand in support of the two Motions. Singapore is a rapidly ageing population. As our society ages, the role of care-givers becomes ever more critical as they help our seniors age with purpose and dignity – in particular, those who need assistance for their day-to-day activities.

Care-givers perform a multitude of tasks, including providing personal care, arranging for transportation and medical care as well as performing tasks inside and outside the home.

Care-givers perform a multitude of tasks, including providing personal care, arranging for transportation and medical care, as well as performing tasks inside and outside the home. They can be divided into two broad categories – professional care-givers and informal care-givers.

Professional care-givers play an important role. They take care of our family members and enable us to continue working. They enable Singaporeans to pursue their careers knowing that their loved ones are in good hands at home. To attract and retain professional care-givers, it is important to ensure that professional care-givers have opportunity for career progression and timely wage adjustments that are commensurate with their skillsets and experience. Relevant and continued training is also necessary to ensure their knowledge is regularly updated to enable them to provide better care to those entrusted to them.

I believe that we can, and must, do more to recognise and support our care-givers. To incentivise more Singaporeans to consider care-giving as a career, I recommend introducing a Progressive Wage Model (PWM) for professional care-givers. There are four important components to the PWM: career progression, wages, skills and productivity. According to studies, the salary of Singapore workers in this sector is lower, compared to other developed countries, such as Australia, Hong Kong and Japan. We have successfully rolled out PWM for several sectors now and I am of the view that it is time we extend PWM to the care-giving industry.

Being a professional care-giver requires passion and dedication. But care-givers face tremendous stress in carrying out their work and the possibility of getting emotionally drained at the end of a day is real. Alongside good career progression, it is also important to have strong support groups to care for our care-givers, too.

Next, I want to touch on support for informal care-givers, who are commonly referred to as home care-givers. These are individuals who have not undergone any formal training on care-giving, nor are they being paid for providing care to their loved ones. These individuals often have to juggle their care-giving roles with a full-time or part-time job. As a society, more can be done to help them. We can provide better support for care-givers in three areas – workforce support, community support and technological support.

First, workforce support. Employers need to recognise that, in an ageing society, their employees will need to attend to elderly family members more and more. Currently, some employers have implemented initiatives, such as parent care leave. However, these are usually limited to just two days a year. I urge employers to provide more flexibility in granting parent care leave. Employers should also embrace flexible work arrangements and allow their employees with care-giving needs to be able to work from home.

Another area of workforce support is supporting care-givers' re-entry into the workforce. Some home care-givers have had to take a few years off their careers to provide care to their loved ones, and it can be challenging to re-enter the workforce with a gap in-between jobs. Can the Government do more to facilitate their re-entry into the workforce? Perhaps, given their experience in care-giving, we can help ease them into the professional care-giving sector. This can also address the local manpower crunch in the industry.

Second, community support. The community plays an important role in supporting care-givers. Monfort Care's Yishun Centre provides care-givers and their elderly with free hand massage and complimentary coffee and tea at their centre. During the interactions, volunteers at the centre also help keep a look-out for the well-being of the care-givers. Last month, a cancer support group "Never Alone" was launched, creating a platform for cancer survivors to share their experience with other cancer patients. They bring hope to those who are struggling with their illness and also increase confidence that they are not alone in their journey. In the same way, care-givers need to know that they are not alone.

This brings me to my third point on technological support. Last year, the "Dementia Friends" app was launched to help care-givers of dementia patients alert others when their loved ones go missing, so that others using the app can help keep a look-out for the missing person. The app also provides useful information for care-givers, such as the importance of self-care. Such apps are useful and should be extended to other medical conditions, such as stroke, diabetic and end-stage cancer. With technology, we can build a virtual community of support for care-givers who often feel isolated in their care-giving roles. Through the online platform, bite-sized training may be uploaded for the care-giver to learn from professionals and others. This would help address the common feedback that care-givers do not have time to attend formal training.

Mr Speaker, it is a fact that it is inevitable that we will all grow old. Some of us will have the fortune to be surrounded by our loved ones who will take care of us no matter what, be it to take on an informal care-giving role, or to hire a professional care-giver. Some, however, will be admitted to a nursing home due to various personal and family circumstances.

I would like to ask the Government to review the current funding model for nursing homes. The current model requires bidders to compete primarily on price. As a result, Voluntary Welfare Organisations (VWOs) and social enterprises like NTUC Health, have to bid low to secure the tender. But this is an unsustainable race to the bottom. Many operators are losing money and the VWOs have to regularly raise funds to cover the deficit.

With a rapidly ageing population and the need to increase the number of nursing home places in the years to come, the charity money may run dry. Losses will mount and the current funding model is likely to unravel at some point in time. Even before that happens, the current funding model already requires our nursing homes to stretch every dollar today. It is not difficult to imagine how a lack of funds can affect the service standards at our nursing homes. Our seniors deserve better and I urge the Government to rethink the way we fund our nursing homes.

Mr Speaker, this Government has shown that it has a heart for our people, in particular, our seniors who have worked hard to bring Singapore to where we are today. We introduced the Pioneer Generation Package in 2015, and we will soon launch the Merdeka Generation Package later this year. With our rapidly ageing population, more can be done by all stakeholders – employers, the Government, the community – to enhance support to care-givers, and to help our seniors age with purpose. With that, I support both Motions.

2.23 pm

Er Dr Lee Bee Wah (Nee Soon): Sir, I rise to support the motion. In fact, I would like to thank my Parliamentary colleague, Mr Melvin Yong, for mentioning the Goodlife!@Yishun and Cancer Support movement in Nee Soon South. In fact, for this Goodlife!@Yishun, we did a fund-raising Golf Tournament. We raised half a million dollars to set up this Goodlife!@Yishun as MOH did not have the budget to support the renovation of this centre. So, on this note, I would like to thank all those supporters who have contributed generously.

In this House, we want to help every Singaporean lead a happy and fulfilling life. As Singaporeans live longer, they spend an increasing proportion of their lives as senior citizens, or care-givers to senior citizens. So, it is timely that we look at how to help Singaporeans spend their silver years happily.

My colleagues have been speaking about several priorities, including employment and volunteering opportunities for the elderly and helping care-givers. I would like to share my constituency's experiences in pursuing these priorities. Employment and volunteering opportunities are important because many elderly still have a lot to give. They want to feel useful to society in a way that is manageable for them. If they have a purpose, it will help stave off issues, such as dementia, depression and so on.

In Nee Soon South, a VWO SASCO runs a café manned by seniors. It is called Give and Take Café and it is right next to Khatib MRT. It is popular with the general public while also being a space for seniors to pursue activities, such as art, model-making, reading and so on. Seniors who work there are paid a small sum, but their biggest takeaway is actually the experience. By working there, they have a sense of purpose and community. And they can connect with customers of different ages who come into the café.

Similarly, at the Goodlife!@Yishun centre, on the other side of the road, we have a small café. Elderly volunteers brew the coffee and tea and make food there together. Anyone passing by can drop in to have some coffee and tea for free. This is when the Montfort Care staff can chat with them, find out if they have any needs and involve them in the centre's activities for elderly and care-givers. Elderly volunteers also run outreach and activities at the centre and the community. Both these cafes are very vibrant. The costs are quite minimal, covered by paying customers or donors. I would urge my colleagues to work with the VWOs in your area and look into similar models.

We are helping care-givers, too. GoodLife@Yishun also features Singapore's first free aromatherapy and hand massage service care-givers. The aromatherapy and massage are done by volunteers, some of whom are our elderly residents that we have trained. The sensory therapy can help care-givers to relax and de-stress. But also, volunteers can take the opportunity to uncover issues the care-givers may be facing. This way, we can identify problem areas early and step in to give assistance. The centre also offers respite to care-givers and support groups for care-givers.

Another thing we are doing for care-givers is promoting a dementia-friendly community. We know it can be very stressful to care for a dementia patient, especially if the patients have to be watched over all the time. We want to build a community where dementia patients can continue to go to the coffeeshop or market like they have always done. This will enable them to age in place and also slow the onset of dementia. It will also give care-givers some peace of mind. Therefore, we are educating the schools, merchants, residents and so on in the area to recognise and help dementia patients. We have added many dementia go-to points, including every RC in Nee Soon South. We have found that senior citizens have a lot to give. They can look after themselves, help other elderly and be the glue that holds the community together.

I would like to share with you two such examples. With the help of HPB, we have exercise classes in every RC, every NC, every park, every pavilion and every condominium. And this is very well-received. In Springleave Estate alone, there are 14 different exercises and the residents are very active. Hundreds of them are actively involved. They bring their family members, their neighbours and their friends. And besides exercises, they also learn new hobbies from fellow residents. Therefore, our elderly residents go out of their homes more often, make more friends and they become happier residents. On this note, I would like to thank HPB for bringing such good programmes and doing great work.

At the part of Nee Soon South, a group of senior residents started community gardening in Zone F. They plant many different types of vegetables. They are very special. They do not plant for themselves. Every time after each harvest, they will be lugging the vegetables, crossing Yishun Avenue 4 to Zone H and they donate the vegetables to the Community fridges meant for residents in the rental blocks. These senior residents are the ones with the golden heart. What they need is just the right support. I urge my colleagues to share what they are doing in their constituencies. We can learn from each other.

We are very fortunate to live in Singapore. We have a good Government who work tirelessly for its people. Hence, we have good infrastructure, the hardware. I hope our businesses, each and every individual, can do our part and help to build the other heartware. In this way, our senior citizens will enjoy their old age to the fullest. In Chinese, please.

(In Mandarin): [Please refer to Vernacular Speech.] Today, we are talking about how to help our senior citizens to truly age with dignity. The programmes we introduced in Yishun South perhaps can offer some ideas.

Near the Khatib MRT Station, there are two cafes, both manned by seniors. One of them is in fact a Senior Activity Centre. Selling coffee can help these seniors earn some extra money, and have common topics with young customers. The other one is a free cafe. It is located within Goodlife!@Yishun managed by Montfort Care Centre. When seniors come in for a free coffee, Montfort Care staff will have a chit-chat with them and invite them to take part in the activities.

Goodlife!@Yishun also features free aromatherapy and hand massage service for the elderly and care-givers. This service and other outreach activities are all conducted by senior volunteers. Through these programmes, we discovered that the seniors can contribute a lot to the society. I hope that the other Members of Parliament can share the experience in your constituencies, so that we can learn from each another.

In Singapore, we are fortunate, we have a very good Government which is always concerned about the welfare of the people, which works tirelessly for its people and provide us with good hardware and infrastructure. I hope our businesses, and each of us will work together with the Government to make Singapore into a beautiful island with good hardware and heartware, whether in terms of money or time. In this way, our senior citizens will live more happily, comfortably, and age in place.

2.33 pm

Mr Zainal Sapari (Pasir Ris-Punggol): Mr Speaker, everyone will be old one day. Ageing is not an option. With increasing life expectancy and decreasing birth rates, there will be more elderly people and we must change our mindset to see ageing as a new stage of opportunity and strength. As a society, we must create an environment where Singaporeans can age with purpose and dignity.

Many of our elderly workers put in long hours of manual labour every day and need their breaks. Ideally, they would spend this time in a proper rest area where they may have their lunch, or just sit down, catch their breath, and find some peace amidst a long, gruelling day.

Unfortunately, there is a glaring absence of proper rest areas in many buildings, especially for outsourced workers who are cleaners, security officers and landscape workers. But there are steps we can take to improve this. And we all have a part to play.

I would like to urge service buyers and building owners to set aside proper rest areas for all workers. In our engagement with building owners, some shared that they are unable to do so because of additional Gross Floor Area charges imposed on them. Hence, I am calling for URA to review and waive the Gross Floor Area charges for a space specifically set aside to set up a rest area. With part of the cost managed, building owners will be more inclined to implement this for their outsourced workers.

Such rest areas will go a long way in improving their working conditions. No longer do they have to find secluded corners, or staircases to have their breaks. They can have a greater sense of dignity and self-worth knowing that their basic needs are provided for at their workplace.

There are also tripartite standards on Age-friendly Workplace Practices, jointly developed by MOM, NTUC and Singapore National Employers Federation. Employers can refer to this to create age-inclusive work practices. The new standard will create an environment conducive for older Singaporeans to work as long as they are willing and able to, in jobs that are safer and smarter, and in a work environment where they feel valued, and where their needs are addressed.

Employers can tap on the age management grant of up to $20,000 to implement good age-management practices, build age-friendly workplace and assimilate their older workers within their organisations. Start by ensuring all workers, including those elderly workers, are properly trained and familiar with work safety and health practices. Employers can also invest in technology to make their work easier and safer.

As an individual, we can be more considerate to make the work easier for our elderly workers. Simple gestures like returning trays at the hawker centres, greeting them and saying thank you can make a lot of difference to these workers. Start today. Make it our habit. Let them know that their work is appreciated. Let them know that they are not invisible. And these workers can age knowing that they have a purpose in life. Let us treat them with respect. At the end of the day, we will all grow older. Would we not all want to age with respect and dignity? Let us treat our elderly the way we would like to be treated when we are old. Speaker, in Malay, please.

(In Malay): [Please refer to Vernacular Speech.] There are many seniors amongst us who work in the cleaning and security sectors. Break times are usually allocated for them but unfortunately, no suitable rest areas are provided at their work place. I feel sad whenever I come across elderly workers who have to take their breaks in a remote corner or have to simply sit at the common staircase area. I think it is important that we take care of the welfare of our seniors who are still working. We must ensure that our elderly workers are able to take their breaks in a suitable environment so that they can perform their tasks properly after they had their rest.

I urge service buyers and building owners to provide a suitable rest area for all workers, including cleaning and security workers. The allocated rest area should at least have tables, chairs, personal lockers and fans so that these elderly workers can take their breaks comfortably. I believe that a suitable rest area can make these elderly workers feel that their work is appreciated and they will be grateful because we recognize them as workers who deserve to be treated fairly.

(In English): Mr Speaker, I support both Motions.

2.39 pm

Ms Denise Phua Lay Peng (Jalan Besar): Mr Speaker, Sir, I rise to support the Motion to continue strengthening support for care-givers. Their needs are not insignificant. Many of them require help in navigating where to get help, where to obtain financial and workplace support, empowerment and training services.

Whilst the parliamentary Motion relates mainly to care-givers of seniors, I would like to focus on one unique group of care-givers. These are the care-givers of persons with disabilities (PWDs); mostly parents who are themselves ageing.

These unique care-givers face the double whammy of dealing with (a) their own ageing and (b) the ageing of their children with disabilities.

Pushed to a corner, some parents end up committing filicide or the act of murder of one’s own child. In 2014, it was reported in local news that the mother of a child with special needs threw him out of their HDB flat, causing his death. The mother, his care-giver, had developed major depression and was seized by the thought that the son was the cause of her misery.

Amongst the thousands of care-givers I have met, there are some, however, who are so willing to give of themselves that they put their child’s interests way above their own.

Mdm Tan, not her real name, lives in a rental flat in my estate. She has two severely disabled children in their late 30s whom she serves, lifts, feed throughout the day. The last I saw her at the house visit, she was exhausted and obviously physically challenged due to the heavy lifting that she does each day looking after her adult disabled children.

Another resident of mine, Mr Lim, not his real name, in his 70s, is a single parent looking after his severely autistic son who is also in his 30s. When Mr Lim fell ill and could not care for his son, the son was sent to IMH for a period, causing great grief to Mr Lim who pleaded for his return. Mr Lim felt he could not even afford to fall sick.

Then, there is another group with whom I have had the opportunity to serve. These are parents who are able and willing to not only provide for their own children but also use their professional skills to build services and programmes in VWOs for disabled children of others. Mdm Loh Wai Mooi, a lawyer, and Mr Ho Swee Huat, a financier, and several others who are my volunteer partners in the special needs sector have been offering their legal and financial leadership expertise for years in the sector.

But whoever they are, one common denominator remains. For everyone of these parents I know and every parent I meet at many focus groups, all of them worry over what will happen to themselves and to their adult children when they themselves lose their mental capacity or pass on.

I arrived at the conclusion that breakthroughs for these families can start only if care-givers are assured that their ageing children with disabilities will be taken care of. Hence, the Enabling Masterplan for Persons with Disabilities developed under MSF, although comprehensive and impressive in presentation, is still not known by many in the community. EMP3 must help deliver and communicate better assurances and outcomes for persons with disabilities in early intervention, education, employment, financial security, healthcare and other cross-cutting issues such as end of life planning. Hence, I urge the Ministry to engage, facilitate and communicate regularly to the special needs community the progress of the Masterplan and to fine-tune the plan as developments occur.

With that in place, the adoption of a systems approach to address the needs of this unique group of care-givers of persons with disabilities would be very useful. I hence propose five steps in a systemic approach of identifying, individualising, integrating, implementing and inspecting the support process of this group of care-givers.

Step one – Identify. Sir, unless we know who, where and what the profile of these care-givers are, it is impossible to support at a sustainable level and add value to their lives. The attempt to develop nation-wide databases of persons with disabilities and their care-givers has not been very fruitful due mostly to a lack of resolve and organisation. However, at local neighbourhood levels, it is highly possible to tap on the current services rendered by organisations such as the Silver Generation Office, Social Service Offices and Grassroots Organisations, a local infrastructure, to develop local databases to identify and locate this group of care-givers.

Step two – Individualise Care-giver Support. Every family is different in needs, abilities and fortitude. Some lack skills, money or other resources to effectively plan, and organise the care for their loved ones. Some are positive and caring while others are negative and unconcerned. In our attempt to strengthen care-giver support in our country, we must beware the cookie-cutter solutions that do not address the individual family situation. Depending on their abilities, whether in finance or skills, and willingness – abilites and willingness – the needs of these care-givers can occur on a continuum and the level of support should be matched to those needs and their changing nature over time.

Some care-givers are able and willing and what they require are regular updates and menu of services they can tap on. Some care-givers are able but not willing and they will need engagement and coaxing to do their part. Some are willing and not able and will need to be trained and equipped. Others who are neither able nor willing will require other forms of support. Hence, we need to individualise care-giver support.

Step three – Integration or integrator. The need for a systems integrator, although it is a term that is usually used in the commercial sector or computer sector, is also a term that is very useful in the social service sector. The need for assistance integrator to facilitate the case management or equipping others to integrate the various needs and solutions cannot be under-estimated. The recent setting up of the physical SG Enable's Care-giver Space is a good start in engaging and training care-givers of persons with disabilities and providing them with information and advisory services. However, SG Enable (SGE) will need to be resourced much more to outreach to many more, beyond its physical premise, and to play the role of an effective integrator or to train others to be effective integrators to facilitate the systems approach I am advocating.

Step four – Implement. As society rapidly ages and the demand for healthcare services and care-giving rises, there will never be enough manpower to perform the roles of care-giving and care-giver support. So, we need to develop a much better coordinated web of local community support that includes neighbours, grassroots, social service organisations, corporate and individual volunteers that will support this unique group and their charges much more effectively.

And the last step is really inspect. The process of care-giver support is an ongoing one and needs and commitment level can change over time, and therefore, tracking and inspection is one of the very key steps to ensure that this systematic and systemic approach of care-giving support is done.

So, in conclusion, Speaker, Sir, the role of a care-giver is a challenging one with multiple stress points. The role of a care-giver of persons with disabilities is even more so. So, unless we further strengthen and resource this last mile of execution, using a more systemic and systematic approach, care-givers of persons with disabilities are at high risk of giving up and in some cases, become so helpless and hopeless. They would even contemplate killing their own children first before taking their own lives. For a first world country like ours, we must never let this happen. Sir, I strongly support the Motion.

2.48 pm

Ms Anthea Ong (Nominated Member): Mr Speaker, I stand in support of both Motions but will focus on care-giving, in particular. I would also like to declare my interest as the Immediate Past President and current member of Society for WINGS – an Institution of Public Character (IPC) and registered charity that empowers women to age well.

It has been said that there are only four kinds of people in the world: those who have been care-givers, those who are currently care-givers, those who will be care-givers, and those who will need a care-giver. Indeed, I was recently at a corporate event and met a most unlikely care-giver, Siti, a young professional in her twenties who became emotional when sharing her care-giving challenges with her three unmarried aunts in their 60s – one suffering from diabetes and depression, another from ovarian cancer and the third from kidney failure. Care-giving affects all of us yet this role is, ironically, one of the most undervalued in our society.

The psychosocial well-being of care-giving must be top of mind for our care-giving policies, Mr Speaker. We have not done a comprehensive national study on care-giver health, which I highly recommend we do. But segmented studies revealed that our care-giver population is certainly facing increasing risk with their mental health. One in five elderly care-givers suffer from depression according to a study by Duke-NUS. A study by IMH in 2017 noted a pooled prevalence rate of 40.2% for depressive symptoms among care-givers of stroke survivors. Yet, another study found that care-givers of cancer patients are at greater risk of developing depression than the general population.

Wendy is one such care-giver who was a respondent to a study by AWARE on the financial cost of care-giving. She is 51 years old, single, and care-giver to her mother who has dementia. She hired a foreign domestic worker to help with care-giving, yet is the "emotional anchor" for her mother. Care-giving has taken a toll on Wendy emotionally, physically and financially. She has had panic attacks and experiences high levels of anxiety. Then, there is Ivan, in his 50s, who is struggling to cope with severe care needs of his 85-year-old mother, also suffering from dementia. Unable to deal with his mother's mounting behaviour issues last year, he had a series of anxiety attacks and ended up in hospital himself.

We all know that with smaller families, there are fewer family care-givers. Over the past few decades, however, Singaporeans have been fortunate to have an army of efficient, dedicated and relatively affordable foreign domestic workers. They form an important part of our informal care workforce. Yet, the same Duke-NUS study found that, I quote, "families who hire domestic helpers are also not necessarily able to relieve this mental stress. In fact, some feel that having domestic help increases this stress. About half of the respondents polled hire domestic helpers and of these, about 55% of the domestic helpers do not have experience caring for the elderly or have received training in doing so."

Mr Speaker, the economic impact of care-giving on the care-giver, and on Singapore, is obvious. The Labour Force Survey 2018 shows that 75,800 women and 13,000 men or a total of 88,800 cite care-giving to families/relatives as the main reason for being out of the labour force. This number does not include care-givers who have had to scale back on work commitments in other ways, for example, by moving to part-time or other work.

Wendy, whom I mentioned earlier, scaled down on her working hours and now earns less than $2,000 a month, about one-fifth of what she used to earn. Ivan quit his job to look his mother, after she repeatedly forgot to turn off the gas at home. Another care-giver, June, stopped working completely when her husband was diagnosed with Parkinson's disease. She is 60 years old and sole care-giver to her husband as they have no children. Their only monthly household income of $1,000 comes from renting out a room in their HDB flat.

Did these care-givers lessen their care-giving burden with formal care services? Wendy tried daycare but her mother reacted violently against it. She is now considering the nursing home option but the guilt is immense and she has been putting it off despite her own deteriorating emotional and physical health. Then there is the cost of nursing home fee that she will struggle with to afford because with her drastically reduced income. June's husband goes to daycare but she holds much guilt because he does not like it there. Yet, she needs that time to go to the hospital gymnasium to exercise her knee. June spends around $300-$400 on daycare, after Government subsidies, plus $100 on transport to her husband's daycare a month against her $1,000 rental income.

Mr Speaker, suffice to say, most of us would like to be cared for in the comfort of our own homes. However, in consideration of care-giver health, the increasingly complex care needs of our seniors and shrinking families, formal home-based and community care services is a critical and practical necessity.

While the Government has been busy increasing capacity in recent years, more needs to be done to improve affordability and quality of these services. The ElderShield Review Committee report estimated that, including transport, consumables and formal homecare services, it could cost care-givers as much as $3,100 per month to look after a severely disabled senior at home, well above the $2,400 median monthly fee for looking after severely-disabled residents in VWO-run nursing homes.

The "Care Where You Are" report by Lien Foundation notes that co-payment of care fees remains a key concern for families, although means-tested Government subsidies for long-term care have been increased to cover up to two-thirds of Singaporean households since 2012. Even for those who are not severely disabled, daycare and homecare services can cost $900-$2,200 per month before subsidies, excluding transportation costs. Families eligible for subsidies must co-pay between 20% and 70%. Those with a per capita monthly household income of more than $2,600 do not qualify for subsidies at all. Costs may therefore deter even middle-income families from using formal long-term care services, especially since many find it cheaper to hire a foreign domestic worker instead.

However, foreign domestic workers, and even family care-givers themselves, may not be trained enough to handle complex care needs and, sometimes, could end up compromising the well-being and health of vulnerable seniors, leading to unnecessary hospital stays.

Homecare is expensive too and appears underfunded with charity dollars, even after accounting for Government subsidies. While the CareShield Life insurance scheme will undoubtedly be useful, given the strict eligibility criteria and that the scheme is optional for older cohorts, how many will join remains to be seen.

Even as we work out ways to improve affordability, emphasis must be made on quality and outcomes. In recent years, many sophisticated new care models, such as the Integrated Home and Daycare Programme, have sprung up. Anecdotal evidence shows that these schemes are good at enabling seniors to be cared for well in the community. Yet, in order to convince skeptical care-givers of the effectiveness of these programmes, outcomes should be tracked and made public.

Mr Speaker, before suggesting some ways forward made in consultation with care-givers and the community, I would like to highlight that Singapore is ageing from a position of relative strength. We have a largely healthy population and there has been considerable focus in recent years on harnessing the blessings of longevity. Yet, we can, and we should do more.

While the importance of enabling seniors to age at home is widely acknowledged, the Lien report also noted that Government spending on home-based and centre-based care, at $240 million in 2016, accounted for only 2.5% of the overall $9.8 billion healthcare budget for the year. The spend in the last two years are not yet available. The Government should consider recalibrating the healthcare budget to enable seniors to age and be cared for at home. More subsidies can be targeted at seniors who are not severely disabled, and therefore, do not qualify for ElderShield or CareShield Life, but likely to benefit from professional rehabilitative care.

To better support care-givers' psychosocial well-being needs, the Government can consider giving seniors flexible care packages, for families to use as they wish, whether for daycare, home-care, respite care services, for transport fees and consumables or to pay a family member or friend for elder-sitting. Respite care should be enhanced to an integrated approach to include counselling and self care training services as well while keeping their aromatherapy and massage services.

Another way forward is to accord the long overdue recognition and appreciation to family care-givers with an allowance or payment, in both cash and CPF credits. This also ensures some level of financial security for them. The payment should vary by the number of Activities of Daily Living (ADL) the care recipient requires assistance with.

To enable care-givers to continue working while providing care, the Government should consider converting paid childcare leave into a longer quantum of family care leave of at least 10 days. And allow it to be used for the care of any family members, including older relatives. In addition, employers should be made a partner in this effort to provide flexible work arrangements on request by employees as well as consistently value the care-givers within their organisations through awareness and appreciation efforts.

Above all, Mr. Speaker, we should collectively embrace care-giving – not as the burden of a few, like Wendy, June, Ivan or Siti, but a responsibility of all. There is an urgent need for more informed collective conversations among Singaporeans about what kind of care system we want for our grandparents, our parents – and eventually ourselves – and how much we are willing to pay for it, whether through premiums and/or taxes, for those who can afford it and to support those who cannot. Because, Mr Speaker, to care for those who once cared for us is one of life’s highest honours.

Mr Speaker: Order. I propose to take a break now. I suspend the Sitting and will take the Chair at 3.20 pm.

Sitting accordingly suspended

at 3.02 pm until 3.20 pm.

Sitting resumed at 3.20 pm

[Mr Speaker in the Chair]

Ageing with Purpose; Support for Care-givers

Debate resumed.

Mr Patrick Tay Teck Guan (West Coast): Mr Speaker, Sir, I rise in support of the Motion, "Ageing with Purpose". At the recent Future Jobs, Skills & Training Forum organised by NTUC, I met Mr Harbhajan Singh, who is an inspiring role model of active and productive ageing in the workplace. Mr Harbhajan is 78 years old, but age does not stop him from contributing his experience, skills and expertise as a Senior Nurse Manager and Emeritus Fellow at Tan Tock Seng Hospital.

In fact, at the age when most have retired, Mr Harbhajan, at 63, was on the frontline when the severe acute respiratory syndrome (SARS) hit Singapore, applying his almost 40 years of nursing experience in battling the communicable disease and caring for SARS patients. Now at 78 years of age, Mr Harbhajan says that as long as he can still contribute, he will keep working at Tan Tock Seng Hospital.

Indeed, our mature workers, who are able and want to continue to contribute in the workplace, are treasure troves of experience and expertise, and more must be done to ensure that they are not overlooked or passed over due to ageist perceptions and discrimination.

I have three observations from the recent MOM Labour Market Advance Release 2018 and MOM's Report on Labour Force in Singapore 2018.

One, while the employment rate for older residents aged 55 and over rose from 57.2% in 2008 to 66.8% in 2018, this is attributed to a tight labour market coupled with an ageing population and declining birth rates. Forty five percent of residents who were outside the labour force in 2018 were aged 60 and over. These residents who are outside the labour force could be a potential source of labour, given the right conditions.

Two, while the number of retrenchments declined in 2018, from 14,720 in 2017 to 11,020 in 2018, professionals, managers, executives and technicians, PMETs in short, continue to be more affected by retrenchments, compared to the other occupational groups. Higher skilled, middle-aged PMETs, being deemed too costly to retain and perceived as too old to be hired, are the hardest hit and most vulnerable.

Three, while the non-seasonally adjusted unemployment rate for PMETs decreased for the second successive year to 2.9% in 2018, from 3% a year ago, older PMETs continue to face greater difficulty in the job market. The long-term unemployment rate for resident PMETs aged 50 and above was at 1.5%, higher than the younger age groups, reflecting greater difficulties faced by older jobseekers in securing employment.

I am concerned and worried that this may be exacerbated by the structural challenges in the labour market.

To encourage active and productive ageing in the workplace, especially in our tight labour market where it is imperative that we maximise our human capital potential to secure Singapore’s competitiveness, all stakeholders have to a harder look at the areas of work, workplaces and workers.

On work. Employers need to look beyond stereotypes and ageist perceptions and see the value of mature workers to draw out this group’s fullest potential in their organisations.

This group of workers not only have extensive work experience, but they are also likely to have a strong understanding of the organisation after many years with the organisation – workers in the older age brackets are more likely to have worked at least 10 years in their current job. In the same theme, they would also have strong and deep domain expertise, and are gems for adjacent and new sectors as well as start-ups.

Employers must recognise that the growing pool of experienced and skilled mature employees in Singapore can help them maintain a competitive edge in the market. To encourage employers to see the value of mature workers, the tripartite partners and industry stakeholders must continue to build on the close partnerships to support mature workers through the advocating and adoption of fair employment practices to ensure those mature workers are not subject to discrimination in the workplace.

At the same time, the following existing schemes aimed at raising older workers' employability, which are coming to an end in 2019, should be enhanced and extended.

One, the Special Employment Credit (SEC) is coming to an end on 31 December 2019. First introduced in 2011 to raise the employability of older Singaporeans, the SEC today provides a wage-offset to employers to hire Singaporean workers aged 55 and above and earning up to $4,000 a month.

Two, the Career Support Programme (CSP) is coming to an end on 31 March this year. The CSP encourages employers to hire Singaporean PMETs aged 40 years and above who have been laid off or have been unemployed and actively looking for work for six months or more.

The NTUC is calling for a three-year extension of the SEC scheme and a two-year extension of the CSP to boost employment prospects of older workers, especially the PMETs.

On workers. We must continue to upskill our mature workers in tandem with industry and business transformation to enable them to keep pace with the new and in-demand skills in their respective industries.

While the training participation rate for our resident labour force for those in the 50-64 age group has increased from 33.7% in 2017 to 40% in 2018, the participation rate in this age group is the lowest compared to the younger groups of workers as the perceived returns on training for this group is lower. Employers can do more to provide our older workers with training opportunities at the workplace to enhance their productive longevity in the workforce.

As our industries transform, the half-life of skills is decreasing. Workers, including our mature workers, need to constantly upskill and reskill to stay relevant and employable and must be willing and open to explore new career opportunities.

Workers can take charge of their skills development and lifelong learning by tapping on their SkillsFuture Credits which was introduced in 2016. As we encourage workers to adopt lifelong learning, it is timely for a top-up of the SkillsFuture Credits now so that workers, especially our mature workers, can take charge of their learning in pursuit of their personal growth.

On workplaces. Our workplaces must be age-friendly to allow our mature workers to continue to contribute as they progress in their years.

Employers need to redesign jobs and adapt workplace practices to take into consideration the needs of our older workers. Under the current WorkPro programme, we have seen real-life examples of how employers have redesigned jobs to reduce labour-intensive processes to make the job more age-friendly for mature workers. These improvements are a win for both the employer and workers as business productivity is also raised through the job redesign.

Under WorkPro, companies can receive grants to support initiatives to implement age management practices via the Age Management Grant, redesign workplaces and processes to create easier, safer and smarter jobs for older workers under the Job Redesign Grant, and implement and sustain flexible work arrangements for all workers. However, the Age Management Grant and Job Redesign Grant will be coming to an end on 30 June this year.

The WorkPro programme ought to be extended and enhanced as we recognise the value of every worker and take steps to increase inclusivity of our workplaces to cater to a more age-diverse workforce.

The Work, Workers and Workplaces which I have mentioned are inter-dependent and must be looked into and addressed in a holistic manner. We must also recognise that efforts to support active and productive ageing in the workplace must be made in parallel with efforts to improve the lived experience of older Singaporeans, such as through measures to help them to age healthily, age well, and have adequate resources to enable them to pursue their aspirations in their golden years.

The Tripartite Workgroup on Older Workers which was set up last year has been looking at the issues and concerns of our mature workers, focusing on four key areas: one, ensuring older workers are valued; two, reviewing the retirement and re-employment age; three, considering Singapore’s next moves on retirement and re-employment age; and four, examining CPF contribution rates for older workers and its impact on retirement adequacy.

The recommendations of the Tripartite Workgroup must address the multi-faceted aspirations, challenges, and needs of our older Singaporeans holistically to enable our older Singaporeans to age with purpose and dignity.

As we push on with efforts to build an age-friendly and age-inclusive workforce and society, I would like to end off with a quote from Mr Harbhajan, as he shares how being able to contribute and learn through his work enables him to age with dignity and purpose and the value of having an age-diverse workforce. He says, "I feel healthy because I am working. I come to work, meet people, socialise with them, I do tasks assigned to me and fulfil my function. This keeps me physically and mentally fit. The knowledge I have can be used to guide the next generation of nurses and benefit them. At the same time, I also learn from them. We must go on with continuing our education. We cannot just stop at one level if we want to progress." I join my fellow Members of this House to support the Motion.

3.31 pm

Mr Ang Wei Neng (Jurong): I applaud PAP.SG's recommendation to keep the CPF contribution rate for senior workers aged 55 to 60 years old the same as those below 55 years old. I have advocated the same in a speech I made during the debate on Annual Budget Statement in April 2016. I support the recommendation that the employer's CPF contributions rate for workers who are are between 55 and 60 years old should remain at 17%.

I have to declare my interest in this relatively sensitive topic of CPF for older workers. As a senior management staff of a large corporation, I would be very concerned of the ballooning wage costs if we were to increase the employer's CPF contribution rate for older workers. However, we have to be objective to look at what is best for Singapore.

Will employers start to replace older workers above 55 years old by large number due to the increase in the CPF contributions? Probably not. With the current tight labour market situation and ageing population, it will be hard for companies to find younger workers to replace those above 55 years old in large number. Will employers start to consciously avoid employing older workers with the increase in CPF contributions rate? Some may, but probably not the majority. Most of the time, job skill, job fit and potential contributions of the employees are much more important contributing factors in the hiring decision. CPF contributions is not the decisive factor most of the time. In fact, with medical and technical advancement, changes in our lifestyle and greater reliance on knowledge workers rather than blue collar workers, the 50s today are our new 40s.

From the perspective of older employees, the increased in employer's CPF contributions will mean a great deal. They will have more money to pay for the housing mortgage, more money to pay for their children’s tertiary education, more money to pay for their MediShield Life, CareShield Life and more. Nonetheless, we still need to balance the interest of employers. For that, I will like to urge Minister for Finance to extend the Special Employment Credits (SEC) for older workers for another three years to cushion the impact of the higher CPF contributions by employer for older workers if that materialise.

Next, I will like to touch on how to better engage the seniors as they age. People's Association or PA, has been doing a good job in organising social activities for the elderly, like brisk walking, craft activities, mass dancing and outings like festive shopping, for example. However, I have observed that most of the time, 80% of those taking part in these social activities are women.

Where are the elderly men? What are the elderly men doing? I am not entirely sure. However, I see many elderly man drinking the coffee at coffee shops. I see many elderly man playing chess games while drinking beer. Although women live longer but the average life expectancy of man has also increased from 65 years old in 1965 to about 80 years old today. Thus, it is important that elderly men, especially after they have retired from their jobs, are socially engaged in healthy pursuits with their friends and kakis.

As a Town Council Chairman, I have started to engage elderly men who are willing to help to inspect the estate for cleanliness, assist in light maintenance work, repairs or simple jobs like changing of light bulbs. One example is Mr Sharim. He is 74 years old He is working with Jurong/Clementi Town Council. He moves around fixing broken locks, patching corroded cement surfaces, and so on. And we are finding more of Mr Sharim and we are expanding the scope.

So, for that matter, I will like to urge PA to take a hard look and design activities that elderly men in the community will like to join. Rather than activities which revolve around social gathering and chit-chat, it may be more useful to come up with "work-based" activities, as men identify with their work or careers much more than women.

It is also good to look at what other countries are doing to engage the elderly men. For instance, we could consider the example of Australia, UK and the US where they have a "Men's Shed" movement . Their slogan is "Shoulder to Shoulder", shortened from "Men don't talk face to face, they talk shoulder to shoulder", which says a lot about how we should engage elderly men.

Men’s Shed comprises of designated space where the elderly men can gather to work on community projects, through carpentry, woodworking and metalworking. The things they make could even be sold, especially simple furniture pieces.

This is a step up from hanging around in the coffee shops, I mean elderly men drinking coffee and beer in the coffee shops. As elderly men spend their time and talents on useful pursuits, they will have a greater sense of achievement and can better contribute to the community. They will also make new friends and feel less lonely.

With an ageing and increasingly well-educated population, there is a growing population of very competent and knowledgeable elderly which we can tap on. Examples are retired head of Government agencies, retired principals, and retired top executives from private organisations. With their wealth of experience, they will still have much to give in terms of leadership and mentorship.

An Economist Intelligence Unit (EIU) survey commissioned by insurance company Prudential Singapore which was conducted recently in March 2018 found that most of those surveyed were still keen to work after the age of 62.

I suggest that for those retirees who are keen to continue contributing, we can put in place a more formalised structure and clearer processes to facilitate the matching of their talents to organisations in need of it.

We could leverage on existing platforms, like Board Match by the Centre for Non Profit Leadership. It matches senior executives with at least five years of management experience and leadership experiences from both the public and private sectors to the Boards of Non Profit Organisations. Alternatively, an appropriate Government agency can take a lead in registering retired senior executives from the public and private sectors to better tap on their talents even during their golden years. Allow me to summarise and conclude in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] We cannot change the fact of population ageing in Singapore. Hence, all of us must work together to allow our seniors to age peacefully. Firstly, I would like to propose that we treat our elderly workers fairly, especially those aged between 55 and 60, so that they can enjoy the same employer's CPF contribution rate as those below 55, which is 17%. Secondly, People's Association or Silver Generation Office must design more appropriate activities which are attractive to elderly men. Current activities for elderly persons are having a tough time in drawing men. Thirdly, we must make better use of retired senior management executives in the public or private sector, so that they can contribute more to the elderly.

3.39 pm

Assoc Prof Walter Theseira (Nominated Member): Mr Speaker, I stand in support of both Motions. The proposals put forward by the PAP.SG's team are comprehensive and insightful. I wish to contribute an economic perspective to the problem of retirement adequacy.

We inherited the CPF system from the British. We have made it into one of the world's most comprehensive social security systems covering housing, retirement and health needs. But we must understand that the fundamental design of the CPF system comes with strengths and weaknesses that today result in several urgent challenges for retirement adequacy.

Let me outline the basic problems of life that a retirement policy must address.

One, there is a mismatch between earnings and expenditures in life. We are able to work in the earlier part of life but we face heavy financial burdens in the later part of life. A retirement policy must transfer money from the earning part to the later part of life.

Two, there are retirement risks that individuals cannot protect themselves against. We cannot predict the number of our days, or whether we will be in good health in retirement. We cannot foresee what will be a good investment decision or bad. A retirement policy must mitigate these risks.

How does CPF address these issues? The CPF system is what pension experts call a fully funded or defined contribution, individual account system. It fulfils the second pillar in the World Bank's "multi-pillar" model of pension systems. It is fundamentally different from the other model of pay-as-you-go state pensions, which is the primary system in many European countries, and which is the first pillar in the World Bank model. The difference is in how you provide money for retirement. In a funded system like CPF, each of us needs to invest enough money into our own individual account to draw on for retirement. But in a pay-as-you-go system, that all retirement money comes from taxes on the current working population.

The challenges facing retirees today under CPF are directly related to this difference in retirement system design. The first challenge is basic retirement adequacy among the Pioneer Generation and the Merdeka Generation; those who are already elderly today.

The CPF Advisory Panel's report noted that in 2013 only 55% of active CPF members were able to meet their Basic Retirement Sumat age 55. This is improving gradually, but we cannot expect this problem to go away in the near future. This problem is inherent to the design of a funded individual account system like CPF which transfers money from the working part of life to the retired part. If there are insufficient savings during working life, there will be insufficient money in retirement.

Now, this lack of money is not because of lack of thrift or lack of hard work in the Pioneer and Merdeka Generations. It is because wages were much lower in the past and many never contributed to CPF because they worked in the informal sector. Life expectancies and medical costs have also risen faster than expected.

How does a pay-as-you-go system address these issues? A pay-as-you-go pillar relies on taxation of the working population. The flaw is that without enough adult workers, such a system cannot pay benefits sustainably. Hence, the importance of the old-age support ratio for such systems. But being able to tax current workers to pay for retirees means that you are not limited to the financial resources of only the previous generation. This is what gives pay-as-you-go pillars the flexibility to make up for unforeseen changes to retirement costs.

To address insufficient retirement adequacy especially among the elderly today, I propose that we formally integrate a basic old-age payout – call it a supplementary pension if you like – with the CPF system. That is, we could formally combine pay-as-you-go elements with the CPF individual savings scheme. We already have the Silver Support Scheme which is effectively a pay-as-you-go means-tested state pension. What I suggest is to combine Silver Support and public assistance for the aged with the CPF system by determining a minimum retirement payout that meets basic needs. The Government would commit to topping-up the CPF retirement payout with this supplementary pension that replaces Silver Support and public assistance. The retirement payout should further be benchmarked to inflation or wages.

Let me address the objection that this will reduce incentives to work and save. The problem we are concerned with is the elderly who are at the end of their working lives and who are facing the prospect of a hard retirement. The supplementary pension can be phased in based on the retirement or re-employment age, to encourage seniors to work if they are able. But once they pass a certain age, they should be taken care of without exception. We can also structure the supplementary pension similar to the Workfare Income Supplement scheme, to fall as a CPF member's own retirement sum rises, but not so rapidly that it discourages work. We can also means-test the payout in the same way as other Government payouts, based on the person’s housing type or family support.

What will this cost? Part of the financing will be coming from funds already committed to the Silver Support Scheme and Public Assistance. The costs will not change. It is just a question of allocation. The benefit of integrating existing assistance schemes is that it makes the CPF system a one-stop shop for your retirement needs. If the benefit amount is more generous than present levels, and it may need to be, then we will have to commit to additional Government expenditure. But I think we are too affluent today to have our elderly work because they have to, and not because they want to. I hope we can ask Singaporeans to make a sacrifice so that unwanted work for the elderly is a thing of the past.

Next, we must deal with our younger cohorts, who have a longer runway to retirement – two decades, or more. We must study whether decisions made today might harm retirement adequacy in the future. Otherwise, our children would end up having the same discussion all over again in 20 years' time. And again, this is a fundamental design issue. In the CPF system, decisions made during working life will have accumulative impact on retirement adequacy decades later.

There are three broad reasons why Singaporeans may fail to save enough for retirement: low contributions to CPF, low rates of return on investment and policy adjustments that have unintended effects on retirement adequacy.

The first issue is low or inconsistent contributions. Some Singaporeans simply do not earn enough to contribute significant sums to CPF. The CPF system, as with many pension systems, is designed for the workforce of the last century. It assumes that a worker will have a lifetime of regular employment. There is no provision for those who are self-employed or those who are in the gig economy. There is also no entitlement for those who exit the labour force, to give of themselves as care-givers.

Low contributions are only a problem because many low contributors also have low incomes. So, we cannot expect that their private savings will be sufficient. So, the best policy for low contributors is to raise their wages and ensure they have more consistent work, by keeping up with our efforts in education and skills training. But where retirement policy is concerned, we should make contributions to CPF as universal as possible. We should work towards making contributing for retirement mandatory even for the self-employed, as is the practice in many countries. But to do this, we must also make contributing worthwhile for the self-employed and the low income.

We must face the reality that the CPF system is often more attractive to the high income, than the low income, simply because the rich do not miss having their CPF contribution money in hand. It is an excellent risk-free asset, but every dollar counts for low-income workers. We must make CPF more attractive to the less well-off Singaporean, which may mean, reducing how generous CPF is to the rich.

One way of doing so is to convert the current tax treatment of CPF contributions from a tax relief to a CPF credit instead. Income tax relief is only worth something if you pay a high rate of tax. This means that CPF contributions are effectively cheaper for high-income Singaporeans. Eliminating the tax relief and replacing it with a tax credit would make the rich pay more in tax, but would give significant boosts to retirement adequacy for the lower income, and it would also pay for itself.

I estimated recently that CPF tax relief costs the Treasury about $1 billion in foregone revenue annually. This is nearly three times the annual cost of the Silver Support Scheme. If that foregone revenue were redirected into a system of CPF top-up credits, we could give all workers about $500 annually as a CPF credit. Because tax relief would be cancelled, higher income workers would pay more in tax than the value of the credit. But the credit would significantly boost retirement adequacy for the broad lower to middle class.

The second reason for failure to save enough is low returns on CPF savings. CPF rates are very competitive as risk-free rates. But they are below rates of return on risky assets. It is not practical nor desirable to expect every CPF member to know how to invest.

So, individual active investing is unlikely to be the solution. Instead, we must look seriously at the implementation of the Lifetime Retirement Investment Scheme, which was recommended by the CPF Advisory Panel in 2015, and which the Government has committed to implement. By offering a simplified, low-risk, low-cost passive investment option, it will minimise transaction costs from active investing, which experts identify as a major reason for the under-performance of retail investors. It will also provide higher expected returns than the CPF system, although with some risk.

The Government should roll out the LRIS as soon as possible, and ensure that through competitive tendering and oversight, management expenses are minimised, and the underlying investment instruments are well-diversified to manage risk. But the LRIS by itself is not for everyone. In particular, the low income, who would benefit the most from a higher rate of return, are the least able to absorb any downside risk. So I urge the Government to study limited protection for downside risk in the LRIS.

One way of doing so is to structure returns, so that volatility increases gradually as the sum invested in LRIS grows. Or it may be to guarantee the risk by pegging the CPF special account interest rate for, say, the first few tens of thousands of dollars, to the current enhanced rates, or to LRIS rates, whichever are larger. This would expose the Government to some risk and expenditure. But it may be better to spend the money upfront, rather than later on the indigent elderly.

Third, the policy context. The CPF system's strength is also its weakness. CPF covers every aspect of social security, ranging from housing to retirement. CPF has also been used to provide employment security by altering CPF contribution rates to keep Singaporean workers competitive.

It is a very fine thing to have so many needs provided for under one large policy umbrella. But sometimes, what you need is more focus. I suggest that the Government set up a dedicated watchdog of the CPF system's role in retirement adequacy. The objective of this watchdog should be to assess the impact of policy and socio-economic developments on retirement adequacy.

There are several significant risks that this watchdog could examine which are, at present, inadequately understood. I will just outline just a few. The projected effect of demographic change and immigration policy on housing prices, and hence, retirement adequacy, because of the potential excessive investment of CPF monies into housing.

The effect of the changing labour market, with increasing informalisation of work and disruption to traditional work arrangements, which together with contribution rate changes, has a direct impact on the build-up of retirement assets.

And, the changing nature of the family, and the implications for inter-generational support, both in money and in time.

The social insurance aspects of the system are also important, but other Members have expressed views there. I will only note that many problems, such as inadequate support for care-givers and dependents, can be addressed within the CPF system itself, such as through granting CPF credits to those who contribute to our society in other ways than paid work.

Mr Speaker, the CPF system has been on many measures a success. We should not let that success blind us. Within the context of the current CPF system, there are many opportunities for reform that will strengthen retirement adequacy today and for future generations. I support both Motions.

3.54 pm

Dr Teo Ho Pin (Bukit Panjang): Mr Speaker, Sir, I rise in support of the Motions. Sir, Singapore has one of the fastest ageing populations in Asia. This will pose immense challenges to Singapore and Singaporeans in the future. However, with the correct approach, the ageing population may prove to be a boon to our nation, while we continue to care for their needs and to support their aspirations.

In order to allow for this to happen, I urge the Government to act fast and to act boldly. It is imperative that we transform our economy, built environment, and lifestyles to allow Singaporeans to live purposeful and happy lives, especially in their golden years.

Sir, I support ageing with purpose and grace. Sir, in order to support ageing with purpose and grace, we need to encourage the 3P, that is, the public, the private and the people sectors to collaborate closely. They must take ownership, and together, champion sustainable policies, projects, and programmes in the community. For the public sector, the Government should implement more pro-elderly policies. Also, works should be expedited to provide an elderly-friendly built environment to encourage seniors to stay active and healthy.

For the private sector, businesses can adopt more pro-elderly business practices to provide meaningful and respectable jobs. For the third P, seniors should seek motivation to lead active, healthy and happy lives.

As mentioned above, we must support the aspirations of the elderly. From my experience, the aspirations of the elderly may be broadly classified under three categories. First, to continue working in either full-time, or part-time jobs; second, to retire and pursue hobbies and passions; and third, to volunteer their resources, expertise, and time for causes they find meaningful.

Sir, having established the aspirations of the elderly in Singapore, I would like to suggest a framework, which was developed by Dr Christopher Cheok, and Angelina Esther David, from Khoo Teck Puat Hospital, which could act as guidelines to suggest how these aspirations may be fulfilled, namely, seven conditions by which emotional well-being and happiness may be achieved.

The seven conditions are first, experiencing positive moments and developing a sense of gratitude; two, pursuing a meaningful career and finding meaning in our work; three, developing good relationships with family and friends; four, contributing to the community and volunteering for meaningful causes; fifth, having adequate financial security; sixth engaging in hobbies which promote mental health; and seventh, maintaining good physical and mental health.

Sir, we could include the framework of the seven conditions to facilitate the fulfilment of aspirations of our seniors. I would like to share in the following four points.

First, call to redesign jobs suitable for seniors. Sir, now that we have established the aspirations of our seniors, and the conditions we should strive towards, allow me to share an example of how the lives of seniors have been improved through an initiative undertaken by Holland-Bukit Panjang Town Council.

Three years ago, Holland-Bukit Panjang Town Council redesigned its horticultural work processes to provide job opportunities for seniors. Collaborating with our landscape contractor, we sought to improve the quality of services through introducing a performance-based contract approach. Through this initiative, we were able to create new job opportunities for seniors to work as town gardeners in our estates. To-date, 23 seniors have been recruited, trained, and employed on a part-time basis.

Sir, it should be noted that these gardeners are aged 60 and above, and experience great joy in working in our gardens. This is a case in point of how employment opportunities for our seniors may be mutually inclusive with achieving higher quality of service.

Sir, it is clear from these examples that there are qualities that seniors possess that place them in a position to contribute to our economy and society, while allowing us to help them achieve their aspirations in a mutually beneficial relationship. Seniors possess many years of work and life experiences and can make meaningful contributions at work if provided with the proper support and pace of working. While it is important to focus on productivity to enhance the competitiveness of our firms, it is not enough to simply focus on quantities – qualities are equally important.

Sir, seniors are usually equipped with skills which make them more adept at providing better customer service. They are also usually more careful and diligent. This will enhance service quality in Singapore, and result in less abortive work due to carelessness. A shift in the mentality of employers in both the public and private sectors is due. Work should be redesigned in order to allow younger and older employees to complement each other's strengths so that we may produce goods and services of high quality and bolster the competitive edge of our firms. I would like to call upon both the public and private sectors to be more proactive in providing employment opportunities to seniors.

Two, call to promote volunteerism. Sir, I would also like to bring the House's attention to North West CDC's healthy living clubs. Over the last 18 years, North West CDC has been promoting healthy living among our residents. Presently, 315 North West healthy living clubs, representing 80,000 residents, of which 40% are aged 50 and above, have been set up, and activities include brisk walking, dance fit, qigong, taichi, swimming and aerobics.

Not only have the activities that these clubs run benefited residents, they have also supported volunteerism for 700 seniors who have become healthy living champions, instructors, coordinators and volunteers. More importantly, many of these seniors have made lasting friendships while maintaining a healthy lifestyle.

Sir, I would like to urge the Government and businesses to continue to support volunteerism and provide more opportunities for seniors to volunteer in the community. At the same time, I wish to invite more seniors to volunteer to make a difference to building a better community.

Three, call to implement successful active ageing pilot projects in the community on a nationwide scale. Sir, I would like to name two volunteers who have run successful community programmes benefiting the elderly.

First, Mr Louis Tay, aged 60, Chairman of Bukit Panjang Community Sports Club. Over the last 18 years, Mr Tay and his team of volunteers have been organising weekly and monthly briskwalking sessions for Bukit Panjang residents. Their passion and contributions have helped many seniors to stay fit and healthy.

Second, Miss Diana Kho. Miss Kho is 69 years old and is one of the fittest dancers in North West Dance Fit Club, as befitting of her status as a master dance fit instructor. She has been instrumental in helping North West dance fit club to grow to its current levels of success. From a humble beginning of four clubs and 400 members in 2007, the club's membership has grown to 62 clubs and 3,500 members today. We are proud that 800 North West dance fit club members will be forming a contingent to perform at this year's Chingay Parade.

Sir, over the years, many active ageing pilot projects have been implemented in the community. However, not many of these projects have been scaled up and implemented nation-wide on a sustained basis to benefit all seniors in Singapore.

Although the profile and interests of seniors many differ depending on the locale, it is important that we develop a national framework and support programmes and projects which have shown success, such as the two mentioned above, to motivate seniors to continue pursuing their passions and strengthening communal bonds.

In light of the above, I propose that Singapore should set up a Healthy Living Endowment fund to support sustainable healthy living programmes. The Government can aid in its set-up and match grants from private donors in order to raise enough funds.

Sir, we need to do more to sustain health living programmes and build a healthy living culture among Singaporeans.

Four, call to augment the elderly-friendly built environment. My next and final point will pertain to the built environment. Sir, allow me to share with the House some projects undertaken by the Holland-Bukit Panjang Town Council to make our town a "Connected and Seamless" town.

First, we have completed three phases of construction of covered linkways and car drop-off points. These link our MRT stations, LRT stations, town centres and bus stops to public estate blocks in Bukit Panjang Town. In addition, we have also built covered linkways connecting blocks to each other and built drop-off porches. These covered linkways have improved the walkability of our town and encouraged residents to walk without letting weather conditions hamper their travel.

Second, we have implemented measures to aid in both horizontal, and vertical mobility. Horizontally, we have built barrier-free access (BFA) amenities, such as ramps and walkways, in the entire town. Vertically, almost all our blocks are installed with elevators, granting access to every level. Based on feedback, these BFA amenities have encouraged seniors, including those wheelchair-bound seniors, to lead active lifestyles, moving around town for breakfast sessions with their friends, chitchatting with their neighbors, and making new friends through engaging in activities organised by grassroots and community organisations.

Sir, I believe that the above should demonstrate the value of an elderly-friendly built environment. Therefore, it is crucial, especially with the backdrop of a rapidly ageing population, that we expedite the building of elderly-friendly infrastructure.

Sir, I cannot stress the importance of providing mobility solutions enough. In a study by Japanese researchers titled Social Interaction and Dementia Prevention: Six-Year Follow-Up Study, it was shown that "greater social interaction was positively related to reduced dementia". A built-environment conducive to active ageing will be of great value in encouraging social relationships and help to delay the onset of dementia in our elderly.

It is on this note that I call on the Government to consider reviewing the funding cap for CIPC projects for the elderly so that more elderly-friendly amenities can be provided to benefit our seniors in the community and give them the opportunity to lead dignified and happy lives.

4.06 pm

Mr Mohamed Irshad (Nominated Member): Mr Speaker, allow me to start with some references and I would like to express my support for both Motions.

According to the United Nations' report entitled World Population Ageing 2013, "Population ageing is taking place in nearly all the countries of the world. Ageing results from decreasing mortality, and, more importantly, declining fertility."

The World Health Organization's concept of active ageing refers to the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age. In Singapore, it is said that by 2030, one in four Singaporeans will be seniors, compared to one in eight in 2015. However, ageing need not cause worry or gloom. If we plan ahead, ageing can be a positive experience for all.

Allow me to highlight three areas of focus for today's Motion on Ageing with Purpose:

(a) Redefining ageing;

(b) Senior volunteerism;

(c) Harnessing wisdom;

Redefining ageing. Sixty is the new 40. Allow me to cite a groundbreaking research published in the journal PLOS ONE in 2013. Dr Sergei Scherbov, from the International Institute for Applied Systems Analysis in Austria, led a project with New York's Stony Brook University looking at how life expectancy has increased over the years. He said: "What we think of as old has changed. Age can be measured as time already lived or it can be adjusted taking into account time left to live. What we think of as old has changed over time, and it will need to continue changing in the future as people live longer, healthier lives. Someone who is 60 years old today, he argues is middle aged. However, 200 years ago, a 60-year-old person would be considered a very old person."

Traditional measures of age simply categorise people as "old" at a specific age, often 65. The study found people across Europe were currently viewed as "old" when they hit 65. However, the researchers predict that by 2050 when people reach their 60s they will be considered "middle-aged". Also, previous research by the team showed that the traditional definitions put many people in the category of "old" who have characteristics of a much younger people.

For the study, the researchers compared the proportion of the population that was categorised as "old" using the conventional measure that assumes that people become "old" at age 65 and the proportion based on their new measure of age, which incorporates changes in life expectancy.

The results show that, as expected, faster increase in life expectancy lead to faster population ageing when people are categorised as "old" at age 65, regardless of time or place but, surprisingly, they lead to slower population ageing when the new measures of ages are used.

We have to ask ourselves if such a study is necessary in Singapore as well to redefine what ageing means. I would like to argue that 70 is the new 60!

On volunteerism, having worked most parts of their lives, I have come across many seniors who want to give back to the community. They actively seek out volunteering opportunities that are aligned to their interests and areas of expertise. Allow me to share a story from my experience in my non-profit organisation, Roses of Peace. Three years ago, we had a significant number of seniors signing up to join as volunteers for our annual distribution of Roses with greetings of peace to promote inter-religious harmony in Singapore. As organisers, we were caught by surprise as we were not expecting seniors to join a youth-focused initiative.

When I spoke to several of of the seniors and asked how they came to know about our initiative, most of them said they came to know about us through Facebook and some of them saidy from friends. Surprised, I turned to the youth and asked them how they came to know about our initiative and they said from Instagram! And if I may add, the seniors were more sporting than our youngsters. So, as an organisation, we decided to take in not just youth volunteers but also those who are youthful.

From my observation, encouraging senior volunteerism will not just promote the values of reciprocity, but also build a caring and inclusive society. We should also look at using social media platforms, such as Facebook groups and WhatsApp groups, to engage and organise volunteering opportunities for them.

On harnessing wisdom, as mentioned earlier, 12 years from now, in 2030, one in four Singaporeans will be 65 or older. That is almost a million people and we should pay greater attention to harnessing the collective wisdom of our seniors and promote inter-generational bonding.

To this regard, Dr William Wan, who is the General Secretary of the Singapore Kindness Movement, has written a book – and very timely, in fact – titled "Through the Valley: The Art of Living and Leaving Well". It covers a compendious array of relevant issues related to active ageing.

In our nation, there are many ordinary seniors like him who have crystallised intelligence that come with age and experience. We, as a nation, must learn to leverage on them for they have still much to offer and contribute. Young people have fluid intelligence which must be complemented by crystallised wisdom which comes only from having been there and having done that.

It is, therefore, important for our nation to respect the seniors in our midst and enlist their continuing participation in nation-building. By bringing the young and the seniors together, we can learn from each other, and bridge the generational gap through inter-generational bonding by working on common projects like racial and religious harmony amongst others.

My generation is made up of digital natives and we can help our seniors to overcome their phobia of the digital world. We can create more opportunities for seniors to navigate the complex world of digital technology. With our fluid intelligence and their crystallised intelligence and wisdom, we can work hand-in-glove to innovate practice systems and to enhance the quality of life and to make our lives together safer and more secure. Therefore, if we can bridge the generational gap today, we can promote the art of living well and leaving well.

Mr Speaker, allow me to briefly speak on the Support for Care-givers Motion. I would like to propose that the relevant Ministry look into establishing a national database of care-givers which allows for systematic tracking of the number of care-givers there are in Singapore. The functions of this platform could include disseminating information relating to care-givers. For example, on care-giver training, subsidies and grants available for care-givers, and letting care-givers view and make healthcare appointments for their care recipients. Mr Speaker, with that, I reiterate my support for both motions.

4.14 pm

Mr Murali Pillai (Bukit Batok): Mr Speaker, Sir, I support the two Motions standing in the names of Mr Henry Kwek and Dr Chia Shi-Lu respectively. My speech today is focused on the Support for Care-givers Motion. The Motion presents an opportunity for us to reaffirm one important pillar of our Shared Values – family as the building block of our nation – as care-givers are most drawn from the family or extended family. It is a point that was emphatically made by Dr Chia Shi-Lu in his speech in moving this Motion and with which I fully agree.

To me, the focus of the care-giver motion is to acknowledge the important role care-givers play in taking care of their senior family members and identify meaningful ways to support them. In the end, our family is strengthened and, in the process, our communities and nation are also strengthened.

There are many care-givers who deserve recognition for what they do. I wish to highlight the case of an exemplary care-giver who resides in Bukit Batok SMC. His name is Mr Noorman bin Semar, 57 years of age. He used to work as a forklift driver. Almost two decades ago, his mother suffered a stroke which left her bed-ridden. She was also severely diabetic. Not only that, he has two elder sisters who are both unwell. His elder sister, now 59, is suffering from a rare disease that affected her spine for the past 20 years, leaving her bed-ridden. She is currently on kidney dialysis, too. Her husband, unfortunately, divorced her when she became bed-ridden. His eldest sister, now 61, is suffering from psoriasis. She suffers from arthritis, too, and her mobility is restricted and is unable to work.

Mr Noorman decided not to get married and focus on taking care of his mother and his sisters. It is a gargantuan task. He needed to carry, bathe, clothe, clean and feed his bedridden mother and sister. He demonstrated to me how he carried his mother, using his arms, instead of tugging at the pyjamas at the hips of his mother's, as he did not want to unwittingly injure her. He learnt how to administer injections, do dressings. He accompanied his mother for every visit to the hospital for treatment. To be able to do this, he gave up his job, took up a security guard job that allowed him to work from 10.30 pm to 6.00 am when his mother was sleeping. At times, he was sleep-deprived. His salary also dropped.

He refused to entertain the notion of getting his bedridden mother and sister admitted into homes. His explanation was this. He said, "This is my duty." He said, "I told my mother, I am your son, do not have to feel embarrassed about me cleaning and bathing you. I will look after you well." This encouraged his mother. Her morale was lifted and, as a result, her life expectancy improved as well.

He also shared that he helped as a volunteer in a nursing home, cutting patients' hair. The Home took care of its patients well. But he noticed that even though the patients are taken care of well, they feel sad because they rather be at their home being taken care of by their own blood relatives. And this is a point that Dr Chia made. For him, it is clear in his mind that only love from the family will ensure that his mother will live as long as possible. He is very proud of the fact that his mother did not suffer bedsores despite being bed-ridden for 18 years. He said that he changed his mother's position frequently so that the pressure on her skin will be evenly distributed. He used a fan to ensure that she does not perspire too much.

He did, however, acknowledge that it is not easy to take care of aged parents generally. He said, in Malay, "Satu ibu boleh jaga sepuluh anak, Sepuluh anak belum tentu boleh jaga satu ibu.", that is, one mother can take care of 10 children, but it is not a given that 10 children can take care of one mother. We must make sure that this does not become a reality. His mother passed away a few months ago at the age of 86. Noorman is at peace now because he knew that he looked after her as well as he could over two decades. His focus now is on his two ailing sisters.

It is humbling to hear about Mr Noorman and his example. It would have been natural for him to get married, have children and send his mother to a home for institutionalised care. He eschewed that in favour of taking care of his mother and siblings personally. He did that out of love and affection. He made significant personal sacrifices and remained steadfast and resilient in the face of many challenges.

As shared by the hon Members who spoke before me, there are certainly other Noormans in our society. And this motion allows us to shine a spotlight on their work. I am glad to note that health institutions have been recognising and encouraging care-givers through presentation of awards and sharing of their stories annually. Their actions keep families together. Children, many of whom will form the next generation of care-givers, would also learn from their inspiring examples.

I suggest that these efforts to recognise these care-givers be scaled up. These stories should be shared more widely. These heroes and heroines must be held up as worthy examples for us to follow. In this way, we can entrench the important social values, such as filial piety. We can do this at the community level through newsletters and community functions, too.

Turning to the issue of support, before we instinctively think of Government support, I would suggest that it is equally important for our respective communities to build ecosystems of support for care-givers. This will have a strong signalling effect and help us build, indeed, a caring environment where residents can seek and obtain help from fellow residents and community partners.

There is much we can do at the community level and hon Members have shared their examples, in particular, a noteworthy speech by Dr Lily Neo. I wish to share some examples from Bukit Batok. For example, in relation to Mr Noorman, through community resources, we provided him with legal assistance to be appointed as his mother's deputy by the Court, financial assistance and medical supplies using resources from the community. We also made available a number of hospital beds to care-givers to help them with the physical task of lifting their bedridden family members for activities, such as feeding, getting them out of bed and so forth.

In Bukit Batok, with the help of South West CDC, our community leaders have been fortunate to partner Care-givers Alliance Ltd to run training courses for residents who are care-givers to family members suffering from mental issues, such as dementia. These residents would then form peer support groups to support each other emotionally. These care-givers, I am told, find this as a very welcome resource.

I would like to also highlight another community initiative put together with the help of NUHS. We formed a group of volunteers who are known as "health peers". We currently have about 123 of them. They are specially trained by staff of NUHS. These health peers make house calls on seniors or attend functions targeting seniors. They then engage the seniors and focus on reinforcing health messages, such as proper exercise, proper eating, following medication and treatment schedules. In the process, they support care-givers in ensuring that their senior family members who are ailing comply with these health messages.

However, there are some challenges that these community efforts face. And one significant challenge is the inability to leverage on patient data. As mentioned earlier, the health peers go from door to door to see whether they can help the families. So, at times, it becomes a bit of a hit-and-miss affair. And it is also an enormous commitment on the time of these volunteers.

This is where I feel that the Government can help through identifying seniors and care-givers, getting their consent and providing the linkage to community programmes. I would welcome the Government's comments on this suggestion because it would really be a win-win situation on the part of the patients, the care-givers, the Government, the community, if we can make it work and there could be leveraging of each other's resources.

On the Government front, we already have existing programmes to help care-givers. Hon Members have today made clarion calls for even more support in terms of CPF top-ups, financial top-ups, care-giver allowance, care-giver leave and so on. These could have assisted Mr Noorman when he stopped working as a full-time forklift driver and worked as a security guard to take care of his mother and sisters. I do agree that more support can be given to care-givers. There is a utilitarian basis to encourage more financial support for care-givers. This may mean less need to provide for institutional-based care or subsidies associated with this. So, there is a basis to assume that there could be some savings that be channelled to care-givers.

I am chary, however, of adding on to financial burden without understanding the full implications. The point to note is that our expenditure on healthcare is already up, as mentioned Mr Henry Kwek. It has increased two-and-a-half times since 2011 to more than $10 billion. So, we need to understand what are the implications, what are the financial trade-offs in deciding how much Government resources should be used to provide support for care-givers, bearing in mind their relative size to the population of Singapore and other needs.

But for me, the non-tangible benefit of strengthening the family and taking care of the well-being of the care-givers should also be borne in mind. I welcome the views of the Government on what it considers to be a responsible approach in providing financial support for care-givers.

In conclusion, I reiterate my support for both Motions and I look forward to the Government rolling out concrete plans to support active ageing and care-givers of our seniors based on the discussions today.

4.25 pm

Miss Cheryl Chan Wei Ling (Fengshan): Mr Speaker, in my maiden speech in Parliament, the central theme was on seniors and how we manage social implications of an ageing society. Then, I introduced the "3G Village" that we aspire to have, one built with care and respect for all ages as everyone has a meaningful role in it. In that, I made several suggestions of how we could embrace our seniors at the workplace and how we can provide meaningful social activities to prevent isolation amongst our seniors. Apart from our seniors, I also noted there is a need to assist their care-givers who are important members of the eco-system in enabling our seniors to age in place and lead active, healthy lives.

Further, in 2018's Motion on Support for Senior Citizens, I raised the need for proactive actions from all in the community – personal prevention to social activeness, senior-friendly townships to social care networks. Like others in this House, we recognise it is time for us to work cohesively as a community towards achieving a country of active seniors.

Today, I wish to focus my speech around some practical challenges and give four suggestions that can assist different groups of seniors in their housing planning and for them to age in place.

One, service provision of Lasting Power of Attorney (LPA) and Will writing for HDB flats. In 2016, HDB flats made up 73% of Singapore's total housing stock. This represents a significant proportion of home dwellers living in public housing. As people age and have changing lifestyle needs, they will transit from one flat to another. While most people today are still able to manage their decision-making process, it is useful to take a precautionary outlook on future needs. Current statistics have shown that an estimated one-tenth of the people aged 60 and above have dementia in Singapore. Half of those aged 85 and older are already diagnosed with dementia. And this number would double by 2030. By then, not only will the seniors' ability to remember, judge or care for themselves deteriorate, it is unlikely that they can benefit from any housing schemes like downsizing to a smaller flat with the silver housing bonus, lease buyback or subletting a room which, in the first place, we have designed all these with them in mind.

Further to health conditions, the growing trend of singles over the past 15 years, as shown in the General Household Survey conducted by the Singapore Department of Statistics, adds on to this challenge. With shrinking family size, it is unclear whether these singles will have the necessary family support to care for them when they aged. But what is certain is that they do require some form of decision making on their behalf if they become mentally incapacitated. At that stage, housing and funds become ever more critical to them. How and who best can make appropriate decisions for them at that point of time?

It is with this thought that I am asking MND to consider the provision of a common service for senior homeowners to sign up for LPA and also Will writing specifically related to their HDB flats. The process can be simplified with some instructions similar in approach to appointing nominees for the CPF account.

As a start, the service can be offered to all seniors who make new flat transactions. Subsequently, this can be extended to homeowners aged 50 and above with an existing flat. This will benefit those who are singles and joint tenancy senior couples to prepare ahead without incurring hefty legal fees and also the complexity for their family in managing the process in future.

Two, review restrictions on CPF savings for housing needs. Many Singaporeans we know finance their housing needs with the usage of CPF savings. This topic is pivotal to many seniors and especially so for those who are lower income group who have been relying largely on their CPF to finance the mortgage loan. The question, of course, remains on how much CPF funds retirees can use for the purchase of flats without compromising their retirement funds. I would like to highlight two areas for consideration.

First, there is currently a cap on the maximum amount of CPF savings that can be used for the purchase of a property with a lease that is less than 60 years. This actually impacts two groups of seniors – the seniors who wish to downsize, and the other who are younger families who wish to purchase the older flats.

There are some seniors who wish to downsize and move closer to their children or siblings for a better care network as they age. For these seniors, I would say, mostly 50 years and above, who have adequate CPF funds in their Ordinary Account (OA) and Retirement Account (RA) to fully pay for the next flat purchase. This cap results in them having to take a loan. The uncertainty of securing a full-time job is high at that age. Some seniors are either not working or, at best, on a part-time work basis. Thus, they typically encounter difficulty in obtaining a loan or have a lower loan quantum if they qualify.

It would be a relief if the seniors can fully pay off for the property and not be burdened by further mortgage at that age.

I must emphasise the point that I am making is not about raising or whether more CPF monies should actually be allowed for use for flat purchase, but rather, for those who have sufficient CPF monies, it is better for them to pay with CPF than taking a loan. As you can imagine, having to worry about monthly mortgage payment or legal fees that ensued from defaulted payment for a shelter that will see them through old age; is a tricky situation that warrants nuance assessment of what is more essential for them as retirement.

Second, the requirement to top up one's RA based on the current age-adjusted Basic Retirement Sum (BRS) after signing up for the lease buyback scheme needs to be reviewed. Some seniors have expressed why they prefer not to take up the scheme as they found that they remain "cash poor" after selling the lease to HDB. With time, the BRS continues to be adjusted upwards and there will be a point when there is little cash proceeds from the scheme unless substantial savings already exist in one's CPF. While this is an option for seniors to age in place if they choose not to move, there are seniors who feel that the price value of the lease they are getting does not proportionately commensurate the value of the flat.

Three, living spaces for underprivileged seniors. For one to feel empowered and age with dignity, they need to first have a place they can live in and feel at ease. And this place is one they can call home. Regardless whether they own or rent the place, it needs to provide comfort when they have little else to turn to.

I know much has been done on the ground. As a matter of fact, I see it in my own constituency of how the different agencies for example, HDB, MSF and VWOs collaborate to put their best efforts in enabling the underprivileged seniors to have a place to live in, socialise and being cared for. But, there is always more that can be done. I would like to suggest further fine tuning of the rental housing policy to accommodate specific groups of seniors who are unable to afford a rental place from the open market. They include:

(a) Seniors with mentally challenged conditions and unable to live with another unrelated person in the same flat;

(b) Seniors who are not officially divorced but have been forsaken by their family; and

(c) Seniors who are diagnosed with terminal or multiple chronic illnesses and wish to cash out from their existing flat and use the monies towards medical treatment.

Some of these underprivileged seniors only wish to have a peace of mind, knowing they have a shelter to live in and to rest in. It takes a whole of community to care for them. But the first step of having a permanent shelter, is more than a baby step for them.

And lastly, provision of innovative transportation mode in a private estate. While the public transport network in the heartland is better connected and provides easier access to the commuters, the same cannot be said for those living in the private estate. In today's context, one can say it is designed as such because more own private vehicles in the private estate and can afford other forms of transport. But in the years to come and with the increased ageing population, accessibility becomes equally important whether they live in the heartland or in the private estate.

With age, the probability of seniors who are still capable of driving and can afford a car will begin to decline. In some private estates, the distance to commute from home to the nearest public transport point can be daunting for the seniors. This is especially so for estates with many slopes, like the one I have, and those frail seniors may need to walk at least 20 minutes or more to reach the first bus-stop.

To help reduce their future transport cost and to encourage greater mobility amongst older seniors, I urge the Government to work with the private sector to begin planning and developing various forms of innovative transport service for the elderly living at less accessible locations within the private estate.

Mr Speaker, to truly show care and concern for our seniors, every action and every thought counts. From policies to community efforts, if we all consciously plan and look ahead to adapt with the changing needs of our seniors, I am certain our collective efforts will be rewarded as we enjoy a country and home that respects, embraces and enables our seniors to age with dignity. And with that, I support the Motion.

4.34 pm

Mr Darryl David (Ang Mo Kio): Mr Speaker, Sir, I rise in support of both Motions, but my speech will focus on the Motion to do with ageing. The population around the world is indeed ageing. This is primarily driven by two key trends – people are living longer than before and birth rates are declining. An ageing population is relatively a new phenomenon since for the most part of human history, the population has been youthful and life expectancy was shorter.

Singapore is experiencing a similar situation; in fact, we could be facing what some people have referred to as a "demographic timebomb" as by the year 2030, 27% of our population will be 65 years and older. This, naturally has significant implications for the country’s economic and social policies.

In the 1970s, Singapore's Old-Age Support Ratio was 13.5, that is, there were 13.5 working age adults supporting every elderly person above 65. This ratio plummeted to 4.8 in 2018. With fewer working adults to support a growing number of elderly, the potential tax revenue from income tax for example has fallen significantly during times when there is an urgent need to increase our social spending to cushion the impact of a greying population.

In recent years, a number of economic and social initiatives have been implemented to mitigate the impact of an ageing population. In public housing, the extension of lease buyback scheme to larger flats allowed more seniors to unlock the remaining value of their HDB flats and have a steady flow of retirement income while continuing to age in their own housing units.

To ensure our elderly can age gracefully within a vibrant community, Kampung Admiralty was designed as an integrated retirement community. In healthcare, the introduction of CHAS, Pioneer Generation and the soon-to-be announced in detail Merdeka Generation packages should help to levitate health cost in this area. I would like to commend the Government for these policies.

Apart from these policies, it is also important, via moral suasion, to convince the elderly of the need to stay healthy and connected, and to support them with targeted interventions. And these are the two areas that I will be focusing on.

First, the need to stay healthy. With retirement age set at 62 years old and re-employment age at 67, Singaporeans are, on average, spending 15.2 to 20.2 years of their life in retirement. It is therefore critical that Singaporeans continue to remain healthy so that they can experience the joy of their post-retirement silver years with their loved ones.

It was a wake-up call for many people when MOH released the statistics that one in two Singaporeans could suffer from some form of disability by the time they reach 65 years old. Many people I spoke to found those statistics troubling because it has never occurred to them that their mobility and lifestyle could be severely restricted in their old age. Underlining these statistics is the important message that everyone needs to take ownership of their own health because we could end suffering from some form of disability if we do not cultivate healthy living and healthy eating habits.

Mr Speaker, Sir, recently I caught up with the old friend from secondary school whom I had not seen for many years. And at the course of our conversation, after reminiscing about old times, the conversation became a little bit bitter-sweet as we started to talk about our peers, many of whom had began to develop, what we call, the lifestyle illnesses – diabetes, hypertension, high blood pressure, cholesterol and so on. The conversation then took a turn to those who had gone for operations – ACL, PCL, ligament replacements and everything. It got quite sober when we discovered that a few of our cohort actually already passed on as well from heart attacks, cancer alike. My friend then shared that he himself had undergone two bypasses and had a stroke – all before the age of 45. This was very sobering and it explained why he looked like he had lost a lot of weight, which was too polite to mention. But the point I am making is that he had no children, married with a wife who was not working and he has already begun to think about what is going to happen to him come 15 years' time when he is in his 60s should his health take a turn for the worse.

When he found that I will be speaking on this Bill, we parted with this word, he said, "Bro, you must make the point. Don't wait till you are in your 60s. You got to start now! Start to eat healthy, start to live healthy, make your preparations." And with that in mind, that I want to make this point, that it is never too early to inculcate healthy living habits.

Apart from spending time educating senior citizens of the need to have healthy diet and an active lifestyle, targeted efforts must be made to reach out to those who are in the younger age brackets so that they too can understand the importance of making changes to their lifestyle early. And I firmly believe that it is this healthy foundation that is laid early on in one's life that will determine one's health and physically wellness in one's later years.

I would urge the Government to adopt a whole-of-Government approach to encourage citizens, especially those 40 years and above, for example. Let us not wait till we reach the 60s, but let us go further upstream, let us start earlier. And to put in place a holistic multi-agency masterplan on how they can make changes to their lifestyle, if we can encourage our citizens to age healthily and develop good lifestyle habits that would build a healthy foundation for the future.

This would involve agencies such as MOH, AVA or the soon-to-be SFA, HPB and even Sports Singapore working together to promote the holistic concept of healthy living. Such a multi-agency strategy could also involve MOE emphasising introducing school curriculums that teach children the importance of a proper diet and having more outdoor physical education hours to promote fitness.

The AVA or SFA, and HPB could jointly mandate the level of sugar in processed food and promote the use of healthier cooking methods. MOH and the network of polyclinics could offer subsidised health screening for those aged 40 and above, and SGActive could set aside dedicated hours for senior citizens to use their facilities at discounted rates to promote the take up of exercise.

To top these suggestions off, I would also urge the Government Ministries and agencies to take the lead to promote better work-life balance by setting aside some time at the end of the work-day, perhaps once or twice a week, so that their staff can be encouraged to begin the habit of exercising regularly.

Next, on staying connected. As we strive to become a smart nation, we need to find more ways to empower our senior citizens to adopt the usage of technology in their daily lives. Based on the statistics collated by IMDA, smartphones seem to be one of easiest ways for senior citizens to get connected to technology.

To encourage senior citizens to venture into the world of technology and to make better use their smart devices, would organisations like the NLB and People's Association (PA) consider working with Institutes of Higher Learning (IHLs), such as ITEs, Polytechnics and Universities, to set up booths at libraries and CCs to help the elderlies with IT-related matters and to teach them how to stay connected through technology? In this sense, NLB and PA would provide the hardware of creating physical spaces where the elderly could learn about technology while IHLs provide the software of teaching the elderly. And of course, we encourage the young youths to also interact with our elderly as well.

I would also urge the Government to consider how it could, perhaps through IMDA, partner homegrown tech-companies like Creative Technologies or Razer and alike, to develop and produce basic smartphones or similar devices with functional smart features like e-payment and internet access for senior citizens. These "uniquely Singaporean" elderly-friendly phones could also incorporate larger fonts and instructions and features in the major languages.

With partners in the telecommunications sector, these basic smart devices could be made available at a nominal rate to all senior citizens above 60 years old, and those seniors facing financial difficulties could even get these devices for free. This would help our seniors transit into the digital era as not every senior citizen is able to afford a smart device. The provision of this smart phone will remove the cost of ownership as one of the potential roadblocks that might impede the adoption of smartphones among senior citizens.

Mr Speaker, the many challenges associated with an ageing population is a classic example of a "wicked problem." Tackling wicked problems requires policy makers to adopt an integrated approach to holistically manage the multi-faceted nature of the issue. Moving forward, it is crucial is for us to identify pockets of opportunity for interventions and implement a holistic suite of programmes to tackle the problem in an integrative manner.

I mentioned earlier that Singapore is facing a demographic time-bomb with regard to the challenge of our ageing population. While a time-bomb is dangerous, as you have seen in many movies, it only causes damage if it eventually explodes.

So, let us all work together as one people, one nation to ensure that we are able to defuse this time-bomb by ensuring that we take the right steps to manage and support our elderly, in a manner that will allow them to age with dignity and grace.

Mr Speaker: I think we are all suitably inspired. May be we should consider replacing our tea breaks with a high intensity interval training. All in favour? [Laughter.] Miss Cheng Li Hui.

4.45 pm

Miss Cheng Li Hui (Tampines): Mr Speaker, Sir, I stand in support of both Motions. The Chinese saying goes, "家有一老, 如有一宝". The senior at home is akin to a gem. If our society is a collective expression of individual homes, then our seniors must be a gem in our society as well.

They have vast life experiences, accumulating wisdom along the way. Although they have worked hard, the reality is not all will be able to enjoy retirement or their golden years. Some will have to continue working. Some may not enjoy the best of health, yet others have to be care-givers to their family members. And as we move this Motion in the House and discuss how we can continue to strengthen our support for our seniors, I would like to discuss in particular our support for seniors who are care-givers.

In my house visits, I have come across more and more seniors who are primary care-giver to their spouse or to their adult children with special needs. Many of them share with me a common fear of their loved ones being stranded when they eventually pass on. This anxiety can undermine their mental and emotional well being if they do not enjoy a wider family or community support.

Channel NewsAsia's "On the Red Dot" programme recently produced a series on the lives of three families who struggle against rare disabilities. Like many Singaporeans, taking in the scenes of their daily living broke my heart. Especially the story of 34-year-old Ms Zakiah. Ms Zakiah suffers from Buerger's Disease, an incurable disease of the arteries and veins in the arms and legs. It causes inflammation of the blood vessels and she has lost her toes and fingers, except her thumbs.

In the case of Ms Zakiah, she has no choice but to rely on the help of her 68-year-old mother, Mdm Musliah. Mdm Musliah helps her daughter to bathe, transfer her from the bed to the wheelchair, contributes financially with her CPF monthly pay out of about $250 and also care for Ms Zakiah's six-year-old son. The physical, emotional and financial stress that Mdm Musliah faces on a daily basis is overwhelming, to say the least. This is one case and she is not alone.

Many of these seniors like Mdm Musliah, also face strained financial resources as they dip into their savings or utilise funds supposedly meant for their retirement in the care-giving process. They are also likely to neglect their own personal well being, such as not seeking medical attention for themselves, or missing medical appointments because of their commitments at home.

At the other end of the spectrum are our seniors who are single with no children, and minimal family support. They are probably the most vulnerable part of society that we need to pay special attention to them. Elderly single or those who lost their partners may also have to cope with the possibility of social isolation and loneliness.

I believe there is scope for more to be done to help this group of seniors. It is important that we mobilise all resources on the ground to help keep a lookout and provide broader community support and awareness for isolated seniors and senior care-givers. Our grassroots, VWOs network and agency such as the Silver Generation Office should collaborate and share data, if possible, to enable better outreach to seniors. In my experience, rental blocks are usually well taken care of by VWOs. However, the lower segment in the three-room or four-room flats, especially those who resettled from kampung and have not made much economic progress are at a higher risk of not being aware of help available.

This group of less educated families do not know much about Government schemes or care-givers' relief programmes. They fall between the cracks, and therefore it is important for us to actively reach out to them.

Another worrying area is medical treatments. Some seniors do not want to seek treatment or say they do not want to know if they have health issues. When I was a volunteer of NUH MediFund Committee, social workers used to tell us that they needed to persuade seniors to seek treatment. They were reluctant as they do not wish to burden their children even if it is a $50 medication. Sometimes a small knee problem without the right treatment and medication causes them to be wheel-chair bound over time and they lose their quality of life.

In the upcoming Merdeka Package, I hope that incentives will be like the PG Package and encourage our seniors to seek treatment early.

After the PG Package was introduced, we saw fewer of such cases, as the seniors did not want to lose out on the subsidies. They cannot lugi. I am sure the Silver Generation Office will do good outreach to our Merdeka Generation but I am concerned if there is sufficient manpower to reach out to such a large group of both the Pioneer and Merdeka Generations.

Lastly, more awareness of the plight of these families and the schemes available to them should be communicated. After the airing of the On the Red Dot episodes, Singaporeans from all walks of life rallied to offer help and support. For many of us, this awareness would not have been made possible without the families’ sharing on such a public platform. I would therefore like to take this opportunity to recognise the production team for their work and sensitivity in putting together this content. And perhaps Ministries can also put up a series on what are the schemes are available to such families. There is no doubt the Singapore society is compassionate and kind. This increased awareness can help us think of what we can do individually to help Singaporeans who are less fortunate. It spurs us on to be more empathetic to our fellowmen.

Mr Speaker, Sir, it is an understatement to say that our seniors play an important role in our society. For our senior care-givers, let us all exercise even greater empathy towards them and help them lessen their worries in their golden years. I support both Motions.

4.50 pm

Dr Intan Azura Mokhtar (Ang Mo Kio): Thank you, Mr Speaker, for the opportunity to speak on this Motion on ageing, the elderly and their care-givers. As one of the last speakers, everything that needs to be said has already been said but let me share my thoughts nonetheless.

As our population ages, there are many ageing-related challenges that we need to address and plan ahead for, so that we are not caught in a situation where older Singaporeans find it difficult to age actively and meaningfully, or stay relevant, and where care-givers to elderly Singaporeans find that there is insufficient support in place to help them care for the seniors living amongst us.

We have begun to put in place measures to help Singaporeans age actively and meaningfully whether through legislation, such as later retirement, re-employment or employment credits for employers to employ older Singaporeans, assistance packages such as the Pioneer Generation Package and the upcoming Merdeka Generation Package or through community-led initiatives, such as Active Ageing Programmes or initiatives led by the Silver Generation Office.

These measures are commendable, and have been crafted and curated taking into consideration the concerns of both employees and employers. However, as with all things, there are still areas for improvement.

For one, I would urge MOM to consider raising the CPF contribution rates for Singaporeans aged 55 years old and above. I have spoken about this matter in this House before. As a Singaporean turns 55 years old, their CPF contribution rate is drastically reduced by 11% overall. I have asked before for this CPF contribution rate to be restored to the current rate of 37% in total, at age 54 years old and below, or even if the CPF contribution rate is to be cut, it should be done progressively over several years, rather than a drastic 11% cut as you cross your 55th birthday.

Second, I would urge the Government to increase the retirement age to 65 years old. Again, I have spoken about this matter in this House before. I gave the comparison to university faculty members on academic tenure which is up to age 65 years old, something that has been offered for about two decades in Singapore. I believe we can and should offer retirement only at age 65 years old across the board, especially when Singaporeans are living longer, marrying later, having children later, and would still need to earn a stable income even well into their 60s. The offer for re-employment should then be from 66 to 70 years old. Companies and organisations also need to change their mindsets about having older employees continuing and still contributing at work. As I have said before in this House, older Singaporean employees have a wealth of experience, wisdom as well as institutional and historical knowledge to share, particularly with their younger counterparts, and they should be valued for this.

Third, there needs to be in place sufficient policies to allow for meaningful employment of older Singaporeans. While we can acknowledge that not many Singaporeans above the age of 60 years old can still carry on with physically demanding or laborious work, they can contribute in capacities such as Trainers, Counselors, Mentors, and Consultants. Companies, organisations and our own public service sector need to explore how job redesigns can be done to ensure older Singaporeans can continue to be gainfully employed with little or no "dumbing down" of their job scopes or work contribution. MOE is a good example of a public service employer of older Singaporeans. Adjunct Teachers are employed even well into their 70s and they continue to contribute to the teaching of young students and the mentoring of younger teachers, without any "dumbing down" of their job scopes or work contribution. I hope more of our public service ministries and agencies can do the same as the MOE, when it comes to employing older Singaporeans.

Next, I wish to speak on care-givers for the elderly. Once again, as our population ages, there will be more seniors and elderly Singaporeans who may need care in their golden years. As we strive to help Singaporeans age actively, stay gainfully employed or remain relevant, there will be a group of elderly Singaporeans who need constant care as they lose the ability to care for themselves due to debilitating illnesses or age-related health conditions. This group of Singaporeans will need care-givers to look after them on a 24/7 basis. Some will be able to employ foreign domestic helpers or professional care-givers, while others will end up getting the care they need in nursing homes. However, there are among us who wish to take care of our elderly parents during their golden and most vulnerable years, out of a sense of filial piety. This may not be an easy decision to make as there are opportunity costs involved, particularly in terms of income. While there are some forms of care-giver support provided by the Government, there is room for this support to be enhanced.

At the moment, the Care-giver Training Grant (CTG) provides subsidies of up to $200 per eligible care recipient per financial year, for the care-giver. In addition, the Interim Disability Assistance Package for the Elderly (IDAPE) provides either $150 or $250 a month for each eligible care-giver of an elderly Singaporean, to cover medical bills or nursing costs, or to hire a foreign domestic helper to assist in care-giving. These are about the only two forms of assistance for care-givers of elderly Singaporeans. I believe the care-givers among us need more support as they care for their elderly parents. I would urge the Government to look into providing more financial support to the care-givers among us who have decided to care for their elderly parents beyond the CTG or IDAPE.

In addition, I would urge the Government to review how more among younger Singaporeans can be enticed to pursue careers in both gerontology and geriatrics. We would need more care-givers for the elderly, more geriatrics-related rehabilitative and occupational therapy professionals, and more gerontology experts to help inform and curate public policies related to the elderly. Plans for more attractive remuneration, career progression pathways and better recognition for those who choose to have their careers in gerontology or geriatrics, need to be put in place. For a start, professional conversion programmes (PCP) and training programmes for mid-career entrants into the gerontology, geriatrics or elderly care-giving sectors can be implemented. More importantly, I hope that as a society we will accord greater respect towards those who choose careers in gerontology, geriatrics and elderly care-giving because beyond just a career, they have chosen to provide care and support towards our elders.

Mr Speaker, we are headed in the right direction in our approach towards seniors, the elderly and elderly care-giving. However, there are still areas in which we can strengthen our policies and initiatives to ensure older Singaporeans remain active, relevant and gainfully employed, our elderly are able to get the care they need, and our care-givers for the elderly can also get the support that would make their choice to care a lot easier. I support the Motion.

4.57 pm

The Senior Minister of State for Health (Mr Edwin Tong Chun Fai): Mr Speaker, Sir, there have been so many thoughtful and considered points which have been raised by various Members in this debate, on an issue which is not only urgent and pressing because of our socio-demographic profile and trends, but also one which shapes the type of society we want to foster and the kind of place we want to grow old in. In particular, Members have spoken about the need for a whole-of-society effort to help seniors age with purpose and with dignity. Members have also affirmed the critical role that care-givers play in achieving this, so that our seniors can better age in place, and, as far as possible in the company and care of those who love them the most. I agree, and the Government intends to introduce measures to help care-givers on their journey.

As our population ages and more Singaporeans live longer, we will see a rise in informal care-giving. By 2030, one in four residents will be aged 65 years and above, close to where Japan is today. Our family sizes are also shrinking. As a consequence, our old-age support ratio will also decrease – from 4.8 in 2018 to an expected 2.7 in 2030. This is a significant shift. As Dr Chia Shi-Lu noted in his speech at the outset, Singaporeans will need support in caring for their loved ones, and working care-givers will need to balance employment and their family responsibilities as well.

I am mindful that there is a broad range of different care-givers, and I think we heard different stories from different perspectives, all of which are very relevant to the debate today. There is a broad range of these different care-givers who operate in a variety of different circumstances and in a very broad landscape and they also themselves wear multiple hats. Some may care for different groups of care recipients, such as seniors, or children, or, as Ms Phua mentioned, Persons with Disabilities (PWDs), or any combination of this. Their needs are diverse, as with their own particular family or care-giving circumstances, so, over time, we will need to look carefully at what these needs are, and whether further assistance might be needed. As a start, and particularly given our demographic shift over the next decade which I have outlined above, I will focus on how we can support senior care-givers as vital partners in our health and social system. Some of the measures that I will outline will also apply to other groups of care-givers, for example, those looking after Persons with Disabilities. And my colleague, Minister of State Mr Sam Tan will touch more on this when he speaks.

As Mr Murali Pillai and Dr Lily Neo noted, many care-givers naturally prefer for their loved ones to age-in-place at home, in familiar surroundings and in the company of people they know and they love. We agree entirely; and it really goes without saying. As such, the Government has been taking the lead to anchor care in the community. Over the years, MOH has strengthened the broad eco-system of support for senior care-giving by expanding the capacity of aged care services.

We have also deepened the range of care options available for our seniors, through new models such as the Integrated Home and Day Care programme. We are encouraged to see higher take-up of home and community care services. As of late 2018, around 16,000 clients have benefited from subsidised home and community care services, an increase from around 14,000 seniors in 2017.

I would like to assure Ms Anthea Ong that beyond just growing capacity from a hardware perspective, we are also working to strengthen the quality of our aged care services through appropriate regulations, developmental services, education, guidelines, service audits, as well as capability-building programmes.

Ultimately, for whatever additional hardware that we put in place, it is the people talent that is the most important, and we agree with both Ms Anthea Ong and Mr Melvin Yong that healthcare professionals play a key role in providing quality aged care services for our seniors.

Between 2012 and 2017, MOH had provided funding support to raise the wages of workers. Salaries of workers across participating providers saw a 30% increase in aggregate over this period of time. MOH also supports skills training scholarships and grants, and productivity improvement and job redesign initiatives, to raise the value of jobs alongside salary increases in line with the intent of the Progressive Wage Model (PWM). We will continue to work with the employers to review salaries of workers regularly to ensure that they are adequately recognised for their efforts. MOH will study if further efforts are needed, including whether to introduce a PWM for the eldercare sector with tripartite partners.

We have also put in place long-term care financing measures to ensure affordable and also sustainable healthcare. Today, we see means-tested subsidies for aged care services, which is complemented by our long-term insurance care schemes like ElderShield and CareShield Life, and a range of disability schemes such as the Interim Disability Assistance Programme for the Elderly (IDAPE), which Ms Intan has mentioned, and the Pioneer Generation Disability Assistance Scheme (Pioneer-DAS). For those who still have difficulty, notwithstanding these programmes, paying for care after Government subsidies, grants and insurance scheme payouts, there are also Government-funded safety nets, such as MediFund and ComCare which can provide further assistance.

Ms Rahayu Mahzam has suggested updating the CHAS eligibility criteria. We agree, and MOH is already in the process of reviewing and, where necessary, updating the per-capita household income criteria for CHAS, so that more Singaporeans can benefit from CHAS subsidies. At the same time, we will also take the opportunity to review the household income criteria for other healthcare subsidy schemes as well.

Taken together, these efforts support ageing in place, living with purpose and dignity, and also provide care-givers with peace of mind.

But we can still do more to directly address the needs of care-givers. In the various engagements that we have had with care-givers since September last year, many shared with us the challenges they face in caring for their loved ones. Whilst they face challenges, they also left us in no doubt how the care-giving journey is itself a very rewarding process. I think that is also the sentiment that many Members here today have expressed. No two care-givers' journeys would be similar, but each of these experiences is bound by the same common desire to care for, and give the best to, their care recipient. We need to help them on this journey.

Therefore, drawing on feedback from the care-giving eco-system and the people operating within the system, MOH, together with partner agencies, have developed a Care-giver Support Action Plan to strengthen support for care-giving. This action plan outlines key initiatives that we will embark on in the next two years.

There are five broad themes which underpin our action plan. Let me just set them out before I go into these in some detail. They are, firstly, Care Navigation; secondly, Financial Support; thirdly, Workplace Support; fourth, Care-giver Respite Services; and finally, Care-giver Empowerment and Training. Let me now outline our key directions in each of these areas.

First, on better care navigation. As mentioned by Dr Chia Shi-Lu, many care-givers, particularly the new ones, the new care-givers, need ready access to information and referral to services, but they may not know so well where to turn, how to navigate the landscape, who to turn to for help, and who to consult in their time of need; particularly the new ones who may suddenly and very quickly embark on this care-giving responsibility.

Today, we have physical touchpoints – AICare Links, operated by the Agency for Integrated Care (AIC) in acute and community hospitals. The AIC Office at Maxwell Road caters to walk-ins from care-givers and seniors alike, and provides information and assistance regarding eldercare services, grants and schemes. The public can also, of course, obtain information through AIC’s helpline, the Singapore Silver Line. These are all useful but, perhaps, not enough. We need to do more to help care-givers feel supported and confident in making informed decisions regarding the care-giving needs of their loved ones.

AIC will create four more AICare Link touchpoints and also embed them in the community at Silver Generation Office satellite offices by the second half of 2019. We agree with Dr Lily Neo that we need to synergise our efforts with Social Service Offices and other government touchpoints within the community, to make service delivery more cohesive and unified, which overall will then better serve the needs of seniors and care-givers alike in the community.

Miss Cheng highlighted earlier the need to look out for elderly care-givers. We agree and through our Community Networks for Seniors initiative, Silver Generation Ambassadors will identify these elderly care-givers during home visits, and link them up with services and support schemes relevant to their particular circumstances and needs.

As Mr Melvin Yong also noted, technology is fast becoming a key enabler in providing care-givers with useful information. The web portal on eldercare and care-giving, Singapore Silver Pages, will be revamped this year, to improve the overall user experience. We will also develop a Health Marketplace e-platform by 2020, where users can more directly access services such as Medical Escort and Transport, and also purchase regular consumables. For such services, it helps that a care-giver has the option of not having to make a trip to a physical office or speak to someone over the phone, just in order to access those services.

As part of our Smart Nation efforts, MOH has been working with GovTech and other Government agencies on a cross-agency Moments of Life Digital Portal to aid Singaporeans, including care-givers, with pre-planning for the end-of-life journey. Features will include step-by-step guidance on issues such as Advance Care Planning, making wills and settling post-death estate matters as well. We will roll out the beta version by end of 2019 and will work with the relevant touchpoints to raise awareness of these pre-planning tools.

Next, let me turn to improving financial support for care-giving needs. Several Members including Ms Joan Pereira, Mr Christopher de Souza, Dr Intan and Mr Chen Show Mao have suggested providing further financial support to manage care-giving expenses, especially for those being cared for at home. From our engagement sessions, many care-givers have indeed shared with us that the cost of care-giving is amongst the uppermost issues in their minds.

Currently, we already have several schemes in place to support ageing in place. These include the Seniors’ Mobility and Enabling Fund to defray the cost of assistive devices and home healthcare items, the Foreign Domestic Worker (FDW) Grant to offset the costs of hiring an FDW, as well as the Care-givers Training Grant to subsidise training. We will build on these, to boost support for care-giving in home and community settings, so as to achieve, amongst others, a delay or even a reduction in the need for institutional care for our seniors.

On that score, I am pleased to announce that we will introduce a new Home Care-giving Grant (HCG) by end of 2019. The HCG will be means tested, and available to care recipients with permanent moderate disability, regardless of age, and granted on criteria which is similar to what we now use for the FDW grant. The HCG can be used to offset the costs of long-term care-giving in the community. The HCG will complement severe disability schemes like ElderShield and CareShield Life, by providing support earlier, and at a stage when care recipients are still able to perform these Activities of Daily Living albeit with some assistance. In other words, HCG will be available at an earlier and less severe stage of disability, when compared to the criteria in disability schemes such as ElderShield or CareShield Life.

The grant will replace the FDW Grant, with an enhanced quantum of $200 per month. Let me explain this. I have earlier said that no two care-givers' journey is similar. Indeed, there are very many differences in the journey and also the way in which care is expected to be delivered.

We have noted Mr Christopher de Souza and Ms Tin Pei Ling's point that care arrangements may vary from person to person, or indeed may even vary depending on which stage of care the recipient might be in. We want to be able to provide financial support which will better meet the range of diverse care-giving needs.

At present, the current FDW Grant can only be used to offset the cost of hiring an FDW. It is therefore limited because not all care-givers might need or want an FDW. So we will replace this with the HCG of $200 per month, which is an increase on the present $120 per month for the FDW Grant, and also allow care-givers greater flexibility on how they choose to use this sum. Some might use it to help with the cost of hiring a FDW, if that is what is needed, whilst others could choose to use this sum to defray the cost of care-giving expenses, such as the costs for home and community-based services, and transportation to medical appointments. There is much greater flexibility in how this grant can be used. Care recipients who qualify can choose to nominate their care-giver to receive the HCG.

Ms Joan Pereira has also suggested that we broaden the definition of family members in Government policies to strengthen familial support. On that score, we agree that family care-givers, first of all, they are usually the first port of call, and fundamentally in the entire eco-system, they are key to supporting our seniors age-in-place. So, we will allow care-givers to use their Medisave to help pay for the healthcare expenses of their Singaporean siblings by the end of 2019. These measures will complement our existing suite of long-term care financing measures supporting family care-givers. So, they come on top of those measures.

Next, more and more families face a growing care-giving burden but also coupled with their own work commitments. So, the workplace environment is a key consideration as we chart this landscape. Employers also have to play a part in creating supportive workplaces. Care-giving leave has been mooted by several Members in this House here today and also before this. While we acknowledge that there are merits to extending leave provisions, we also need a sustainable approach that balances the needs of not just employees but also employers in the long term. This was a point which was widely discussed at the various consultations we had with care-givers.

As Dr Chia Shi-Lu noted, many care-givers see Flexible Work Arrangements (FWAs) as being more useful to helping them meet both their work and care-giving commitments, and balancing them in the longer term in a more sustainable way. For example, working care-givers would like the flexibility to be able to take time-off to tend to their loved ones’ needs. Often, they do not need a full day or even half a day, and, perhaps, two to three hours might be sufficient in some circumstances. Other care-givers may require flexibility to work offsite on occasion whilst they take care of their dependants. In our view, a better and more sustainable long-term approach to this issue would be for employers and companies to develop their own FWAs which can best support care-givers in the workplace.

In addition to FWAs, as Mr Melvin Yong noted, some care-givers wish to re-enter the workforce, and need more support as well, such as in up-skilling and job-seeking. My colleague, Senior Parliamentary Secretary Low Yen Ling will be sharing more details of our recommendations to support these groups in her speech later.

I turn now to the point made by various Members on the importance of care-givers being able to take occasional breaks during their journeys to rest, recharge and sometimes to deal with their own particular circumstances as well.

Sometimes, a respite is not even a luxury because some care-givers might require the respite at short notice due to their own exigencies. They cannot always anticipate when they might themselves fall ill, or when they might have an urgent matter to deal with. How they are going to be able to take some time off to tend to these exigencies while at the same time ensuring that their loved ones remain cared for remains a significant burden.

Respite services within home and institutional settings are already presently available. To date, over 2,400 clients have benefited from respite services in senior care centres and nursing homes. But again, we can do more, and MOH will be enhancing our suite of respite options so that more care-givers can benefit from respite services. We also want to ensure that care-givers can access such services in a shorter period of time.

For instance, we have heard from care-givers that seniors with dementia can sometimes have difficulty sleeping and resting at night. In fact, some of these seniors with dementia can be quite active at night. Ms Tin Pei Ling shared about care-givers who find it challenging as their own sleep then becomes disrupted when they need to tend to the seniors at night, especially if they also have to juggle work commitments in the morning. To support such care-givers, AIC will pilot a new night respite service for seniors with dementia who may have sleep and behavioural issues. AIC will partner a few nursing home providers to provide this new option where seniors with dementia can be engaged through activities at night while their care-givers can catch up on their own rest.

As I mentioned earlier, the need for respite services can be unpredictable and we need to be able to cater for care-givers getting respite quickly and efficiently. Dr Chia Shi-Lu suggested allowing families to pre-register essential information with providers. We have been studying this idea and will pilot a pre-enrolment system this year to further reduce the time required to activate respite services. Under such a system, care-givers can pre-register their loved ones and complete some of the otherwise lengthy and somewhat laborious administrative processes upfront. Later on, when the time comes for the respite services to be availed of, providers would already have some of the key information, and this would help to cut down the administrative process and time required to enrol the senior. AIC will try this out with a few providers first, iron out any operational matters as they study it for a period of time and then look to expand this to more providers.

We will also pilot a home-based respite service for care-givers of palliative care cancer patients. Care-givers of terminally ill patients are fulfilling the desires of their loved ones by caring for them and also enabling them to pass on at home. This is often physically and emotionally tiring. The pilot would provide custodial care service for home palliative care patients so that care-givers can take a break with the knowledge that their loved ones will still be well taken care of at home.

Next, let me touch on care-giver empowerment and training. As members have noted, beyond just having a strong suite of formal services to support care-givers, good socio-emotional support for care-givers is also crucial. We already have community outreach teams who currently reach out to those at risk or those with mental health illnesses. We will evolve some of these teams to provide a more dedicated focus on care-givers. These teams will provide outreach to care-givers, provide case management and support through counselling, and also offer socio-emotional programmes. AIC will pilot these community outreach teams with community providers, such as Care-giver Alliance Limited, by the end of 2019.

We will also facilitate more care-giver support networks being set up. Care-giver support networks provide a safe environment for care-givers to come together, share their care-giving experience, lean on each other, support each other, which is often needed during the long and oftentimes difficult care-giving journey. Take the example of Mdm Theresa Toh who cares for her 68-year-old sister with schizophrenia and attends Queenstown Care-giver Connect, a support group for care-givers. Queenstown Care-giver Connect helps Mdm Toh with self-care by organising talks on mindfulness and communications with her loved ones. She has also, through this programme, met with fellow care-givers with whom she has now a strong friendship and there is a group to lean on and someone with whom she can empathise with. We plan to expand more of such care-giver support networks through our Dementia Friendly Communities.

Ms Anthea Ong noted that it is critical to equip our care-givers with the right skills and the relevant knowledge through training. Many households rely on FDWs to support their care-giving needs and we want to equip them with the relevant care-giving skills upstream so that they can take better care of our seniors. On that note, we will enhance eldercare training for family care-givers and also new foreign domestic workers early on in their employment in Singapore.

On this note, I am very encouraged to hear about the several community and ground-up initiatives to recognise and support our care-givers mentioned by Members, such as Mr Murali Pillai and I think Er Dr Lee Bee Wah as well, to build a support structure to reach out, to empathise with and help care-givers on this journey. I think we would agree that everyone in society has a part to play in this care-giving journey. I have heard many Members expressed that sentiment and I agree entirely.

For instance, the Care-giver Alliance Limited partnered the Chinatown Heritage Centre and Nanyang Polytechnic (NYP) this year to organise an event for care-givers and their loved ones at the Centre. Care-givers had the opportunity to network and share experiences while nursing students from NYP role-played characters from the past and conducted therapeutic and fun activities to engage the young and old alike, including baking, childhood games and paper art. We will continue to work closely with community partners, such as Community Development Councils and grassroots organisations, to strengthen community-level support for care-givers, as Mr Murali Pillai has suggested. In response also to Mr Mohamed Irshad's suggestion to more systematically track care-givers, our various initiatives will give us the opportunity to collect more comprehensive information on care-givers to better understand their profile and needs and what else could be done to enhance the support given to them.

Mr Speaker, my belief is that all care-givers are committed to providing the best care possible for their loved ones. They do not complain and they are often determined and resilient in overcoming the challenges that come their way. Care-giving journeys may be long, but we can go the distance if families and communities come together to support care-givers in our midst.

This is not just about grants or hardware or programmes. It is also about appreciation and empathy and, in the words of Ms Anthea Ong, about embracing care-giving as a society to ensure that we not just provide the physical and hardware support but also the socio-emotional support that we owe care-givers. It is about nurturing the kind of society we want to foster.

The Action Plan reflects the Government's commitment to strengthen support for senior care-giving and our call for a whole-of-society effort to partner care-givers in their care-giving journey. Each of us must do our part to recognise, value, support and celebrate care-givers. Together, we can support and empower care-givers and, in turn, help our seniors in Singapore to age-in-place with dignity, in an environment which they know well, and with people who care and love them.

On this note, Mr Speaker, I support the Motion.

5.23 pm

The Senior Minister of State for Health (Dr Amy Khor Lean Suan): Mr Speaker, MOH supports both Motions. Healthy longevity presents opportunities for us to transform ageing into a positive force. We are second in the world for healthy life expectancy at birth, after Japan and ahead of South Korea. Japan has already started challenging the notion of what "old" means. The Japan Gerontological Society shared a report in 2017 which recognised how their current seniors are much fitter than past generations, and suggested redefining "old" as those “over 75". We can redefine ageing and turn it into a positive force if we embrace longevity and its opportunities.

In 2015, we set out to do this with the Action Plan for Successful Ageing, a $3 billion plan with more than 70 initiatives across 12 areas to make Singapore a Nation for All Ages. We have made good progress on these initiatives, including on senior-friendly designs, as raised by Ms Tin Pei Ling.

As we continue to make progress on these initiatives, we need to plan ahead for successive generations of seniors who have different needs and aspirations. The Merdeka Generation seniors, for example, are living longer and healthier and are more educated, skilled and IT-savvy, compared to our Pioneers.

MOH is strengthening efforts in three areas to enable Singaporeans to look forward to their senior years with confidence and grace. We call it the "3 E's" framework – one, Empowering good health and active ageing; two, Enabling communities of care; and three, Evolving new models of ageing in place.

First, we want to empower seniors to stay healthy and active and provide opportunities for personal development and community participation so they can continue to find purpose and meaning in their senior years. Good health is a life asset that we must continue to invest in. We have expanded the reach of preventive health services to seniors in the community in recent years. Last year, we rolled out Project Silver Screen, in partnership with Temasek Foundation Cares, to check seniors' vision, hearing and oral health, at low or no cost, and follow-up on abnormal results if needed. About 45,000 seniors have benefited from this nationwide functional screening programme since January 2018.

We are also leveraging our network of about 3,000 Silver Generation (SG) Ambassadors to proactively assess seniors' health status when they visit them at home and encourage them to participate in the preventive health and active ageing programmes in their neighbourhoods. Beginning with the Pioneers in 2014, our SG Ambassadors have made more than one million home visits and engaged about 450,000 seniors aged 65 years and above.

As noted by Dr Lily Neo, we are also extending active ageing programmes to more communities. By 2020, two in three Residents’ Committees (RCs) nationwide will host active ageing programmes. We agree with Mr Daryl David that efforts to inculcate healthy living habits among seniors should start early.

One of the ways we do this is by targeting mature workers aged 40 and above through HPB's workplace health programmes. Over 60,000 mature workers in seven sectors, including transport and security, have participated in such programmes which have been customised to each sector’s workplace environment. In line with his suggestion for a multi-agency approach, we formed the HealthySG Taskforce in November last year to coordinate an integrated approach across public agencies to encourage Singaporeans to adopt a healthy lifestyle. The taskforce, chaired by Senior Parliamentary Secretary Amrin Amin, is in the process of gathering feedback and ideas and we look forward to the public’s contributions.

Ms Joan Pereira and Dr Lily Neo suggested building more Senior Activity Centres to promote wellness activities close to where seniors live. Besides Senior Activity Centres, we have also been siting such programmes in eldercare facilities to provide a continuum of active ageing and care services to seniors in the community. One example, as shared by Ms Joan Pereira, is the “Wellness Kampung” initiative in Yishun. Piloted in 2016 as a partnership between Yishun Health, St Luke's ElderCare and the Nee Soon grassroots organisations, the network of three wellness and care centres provide wellness activities, such as healthy cooking demonstrations and recreational activities, as well as day care and rehabilitation services for frail seniors.

MOH is also building larger day care centres called "Active Ageing Hubs" which offer a range of active ageing and care services, similar to the "Wellness Kampung". We have opened five such hubs to date and expect another five by 2020.

Going forward, we will work closely with community partners to provide a good range of customised active ageing programmes to suit different profiles of seniors in their neighbourhoods.

While the gender diversity debate in the corporate world has been cast as a shortage of women directors in listed and non-listed companies, it is interesting that the problem is reversed for our seniors in these programmes – men are scarce in this space! Anecdotally, our community partners share the same observation as Mr Ang Wei Neng that only about one in five or 20% of their participants are men. Even for senior learning courses, only about 30% of the participants are men. So, where have all the men gone? We agree with Mr Ang that there is scope to increase male participation in our active ageing programmes and are determined to do so.

The example he shared of the Mens' Shed movement in Australia is interesting, as it recognises that men find it easier to make friends through work-based activities, such as carpentry. We may not have backyards or sheds like in Australia, but we have our void decks and common spaces, where we can see our men at work.

For example, in Kampung Senang, male senior volunteers under the "Silver Mobility Aiders" programme help to maintain and service wheelchairs for their fellow seniors. In Yishun, the "Repair Kakis", a group made up of about 15 men who used to be technicians, electricians and engineers, get together weekly to help repair, assemble and fix various electrical appliances brought in by their fellow residents.

I am encouraged to hear that Mr Henry Kwek is planning to bring in more communal sports for the senior men in Kebun Baru. Indeed, we need a concerted effort to find meaningful activities and innovative ways to bring the male seniors together and create local versions of these mens' sheds. For a start, MOH welcomes suggestions from all the men in this House, on new active ageing approaches to get men not just to talk, but also to learn and play "shoulder to shoulder".

We also want to support our seniors' aspirations to continue learning. Today, the National Silver Academy (NSA) offers over 1,000 courses for seniors to pursue their interests in a wide range of areas, such as art, wellness and life skills. These courses have attracted some 26,000 participants thus far.

We will continue to grow the senior learning opportunities under the NSA, including in areas such as IT and digital literacy, as suggested by Ms Pereira and Ms Tin, and make them even more accessible by bringing more of these courses into the community. Seniors can also utilise their SkillsFuture Credits for many of the NSA courses to learn new skills that can help them find freelance work opportunities, as suggested by Mr Henry Kwek.

We recognise that seniors are invaluable assets to the community, and we want to empower them to contribute their knowledge and wisdom by volunteering. One example is 68-year-old Mr Chia Shih Thow who started volunteering with Montfort Care 10 years ago after he attended their Young At Heart (YAH!) programme. Mr Chia was inspired to hear of other senior volunteers through the programme and signed up as a Health Ambassador first, before taking on other roles, such as medical escort, befriender and games facilitator. He is now back at where he discovered his passion for volunteering, inspiring others as a group facilitator in the YAH! programme.

To help others like Mr Chia give back to the community, we have set up the Silver Volunteer Fund (SVF) to provide funding by community-based organisations that create volunteering opportunities for our seniors. We have other sources of funding to support good ground-up initiatives, such as the Tote Board Community Healthcare Fund (TBCHF) and the Community Silver Trust (CST) dollar-for-dollar matching grant which was extended to active ageing programmes in 2017. We will continue to review the funding for such programmes, including the suggestion by Dr Teo Ho Pin to set up a Healthy Living Endowment fund.

Second, we want to enable strong and cohesive networks of care that support all seniors, especially vulnerable seniors, to age in place with dignity. Senior Minister of State Tong has talked about how we can strengthen support for family care-givers. The community plays a key role in supplementing and complementing the care and support provided by families to build a robust community care eco-system for our seniors.

We envision such an eco-system to be underpinned by four key layers of support. First, through the "preventive health home visits" which I talked about earlier. Second, by providing a systematic and comprehensive range of preventive health and active ageing programmes, such as chronic disease screening and nutrition classes in the community. Third, building up a network of befrienders in the community. And fourth, linking them up with the necessary care and support services.

Mr Henry Kwek talked about the importance of local coordination. Our Community Networks for Seniors (CNS) initiative, which I am pleased to report has been expanded nationwide now to 89 neighbourhoods and areas, brings together stakeholders on the ground, including Government agencies, care providers and community organisations, to close the last mile delivery of active ageing programmes and care services, and provide timely and coordinated care for our seniors when needed.

We agree with Miss Cheng Li Hui that more support should be extended to vulnerable seniors who are at high risk of social isolation and loneliness. Mr Faisal Manap also raised the issue of elderly suicide.

To clarify, while the number of elderly suicides has increased in recent years, along with our ageing popular, the suicide death rates among our elderly have, in fact, declined over the past decade. The suicide rates amongst Singapore residents aged 60 years and above, fell from 22.4 per 100,000 residents in 2007 to 16.4 in 2017. Nonetheless, each suicide is one too many.

Hence, we will further strengthen our efforts to prevent suicides by proactively reaching out to pre-empt social isolation and provide support for those at risk. For example, our SG Ambassadors today are trained to identify seniors at risk of social isolation when they make their home visits, and will proactively link them up to community befrienders in their neighbourhood who can check in on them regularly.

Care Line, a 24-hour senior helpline, which will be expanded nationwide, also calls seniors regularly to check whether they are well and provides urgent assistance if seniors call in, distressed. Our community outreach teams managed by community service providers also reach out to seniors with or at-risk of dementia and depression.

Er Dr Lee Bee Wah shared examples of how the senior residents in her constituency help other seniors. Indeed, seniors find it easier to relate to and befriend other seniors, for example, by being able to communicate in their native dialect and mother tongue.

They are a valuable volunteer resource pool to tap on, as highlighted by Ms Pereira. In fact, four in five community befrienders and one in four of our SG Ambassadors are senior volunteers.

Building communities of care involves our younger generation as well, and I am heartened to hear of the intergenerational initiatives shared by Mr Mohamed Irshad. The Council for Third Age (C3A) organises intergenerational learning programmes which provide opportunities for seniors and students to interact and learn from each other.

More than 20,000 students have participated in such programmes to date. Under the Action Plan for Successful Ageing, we are also co-locating childcare and eldercare facilities, such as those in Mr Christopher de Souza's ward, to facilitate inter-generational programming.

Third, we want to continue to evolve our typologies of ageing in place to meet the needs and aspirations of future generations of seniors. In recent years, the Government has announced efforts to ensure that our current and upcoming cohorts of seniors, such as the Merdeka Generation, have greater assurance for issues of concern to them, such as coping with healthcare expenses. More details on the Merdeka Generation Package will be shared at Budget. I will also share more about how we will reach out to the Merdeka Generation seniors at the Committee of Supply this year.

We need to anticipate what future generations of seniors might deem important to age in place gracefully and confidently, and be prepared to evolve our models of care, or experiment with new ones.

Mr Melvin Yong has suggested a review of the current Build-Own-Lease (BOL) funding model for nursing homes. We do regularly review our nursing home development costs and nursing home development models. Our BOL framework introduced in 2012 has allowed us to ramp up our nursing home capacity to meet the needs of our frail seniors.

Under this framework, the Government pays for the capital costs of development, and tenders out the operating rights to both private and VWO operators so these operators do not have to bear the upfront capital costs. This model also allowed us to encourage quality care as providers are evaluated on the quality of their proposals, which includes aspects like model of care and community integration plans.

Our tenders allow providers to propose how much they intend to charge patients based on what is sustainable to them, and the price competition helps keep nursing home fees affordable for elderly residents. We also regularly review our funding for nursing homes, separately from the providers' fee bids, to ensure providers are adequately funded for the services provided to subsidised residents. In fact, we recently reviewed and increased funding for nursing homes in 2018. We will continue to review our BOL framework to ensure that nursing home residents can access good and appropriate care at affordable fees.

We continue to find innovative ways to mobilise community resources to better support our seniors, such as in the area of transport raised by Miss Cheryl Chan.

The Agency for Integrated Care (AIC) had worked with private-hire companies, such as Grab to train their drivers to help seniors, who have limited mobility or are in wheelchairs, get into or out of the car safely to bring them to their medical appointments or to senior centres. The GrabAssist service is also available for those who wish to book a ride from the over 1,000 drivers that have been trained to-date.

Another area we are looking to evolve new typologies of ageing in place is in the staging of assisted living services within housing estates. In 2014, we piloted "in situ" care precincts by staging care services and assisted living support out of Senior Activity Centres within rental precincts through our Care Close to Home (C2H) programme. C2H is currently offered at 15 sites across Singapore, including in Dr Lily Neo's ward, serving more than 3,500 clients.

We are reviewing how we can develop new options of assisted living for seniors to facilitate ageing in place, as suggested also by Mr Henry Kwek, Ms Pereira and Ms Mahzam.

As announced at the Committee of Supply last year, MOH is working closely with MND to develop new assisted living options that include care services. More details will be shared at the Committee of Supply this year.

Longevity is not a curse but a blessing and offers us possibilities to live more meaningful and productive lives. As future cohorts of seniors are more educated and skilled, there is no better time to take advantage of our longer life years than now.

Mr Speaker, I am a proud member of the Merdeka Generation, and wish to end my speech by encouraging my fellow Merdeka Generation seniors to embrace our longer life years, be positive and proactive, so that we can age successfully. I personally believe that there is no better investment to make than that in good health. As the Chinese saying goes, "Health is Wealth" or "健康是财富".

Just as the Pioneer and Merdeka Generations have each played key roles in shaping Singapore's early years, we all have a responsibility today to shape our communities to build successive generations of successful agers. On this note, Mr Speaker, I support both Motions. [Applause.]

5.45 pm

The Minister of State for Social and Family Development (Mr Sam Tan Chin Siong): Mr Speaker, Sir, another member of the Merdeka Generation is speaking now.

Sir, care-givers are the first line of support, and for some, the only line of support, for their loved ones, and their roles can be physically, mentally and emotionally demanding. As shared by a few Members earlier, it is not uncommon to find care-givers neglecting their own well-being, or suffering from burnout, when taking care of their dependants. This is why "Supporting Care-givers" is a key thrust of our Third Enabling Masterplan (EMP3). Through EMP3, we want to help care-givers provide the best possible care to their loved ones, and also to take care of themselves.

Care-givers of adults with special needs and care-givers of seniors actually face similar challenges, such as physical care tasks, care affordability, accessing information and maintaining their emotional well-being. Allow me to highlight how care-givers of persons with special needs will benefit from the Care-giver Action Plan.

The Home Care-giving Grant that MOH will introduce to replace the Foreign Domestic Worker Grant will provide much-needed support for care-givers of persons with special needs. It will increase financial support for care-givers of individuals with permanent disability, who require assistance to perform at least three Activities of Daily Living (ADLs). In addition, the grant can also be used for a broader range of support rather than just for hiring foreign domestic workers. For example, it can be used to pay for out-of-pocket expenses such as Day Activity Centre fees.

MOM is also encouraging more employers to incorporate Flexible Work Arrangements (FWAs) to reduce stress faced by working care-givers. FWAs give working care-givers greater flexibility to manage their time when the care-giving need arises.

Beyond the care-giver action plans, MSF and our partners also support care-givers through various initiatives targeted at helping care-givers across life stages. Allow me to share some of these examples.

We are improving support for care-givers and parents of children with developmental needs. Earlier this year, MSF announced that we will make Early Intervention services more customised to the developmental needs of children, and also make them more affordable. Children under two will receive intervention under a new EIPIC Under-2s programme. This programme focuses on training parents and care-givers to include intervention strategies in the child's daily routines in their own home. We will also increase subsidies so that early intervention services are made more affordable.

Taking care of persons with special needs is a lifelong journey, and for some, a lifelong commitment, and the support and guidance from other care-givers play an important part in helping them overcome difficult times. For this purpose, SG Enable has been working with the community to facilitate peer-to-peer training, to equip care-givers with the skills to mentor and guide other care-givers.

Last December, Minister Desmond Lee launched the Care-givers Pod at Enabling Village. This is a space specifically set aside for care-givers to take part in peer support activities and care-giver training. Beyond being a place for care-givers to meet, the Care-givers Pod is also a platform for them to connect and share experiences and expertise and strengthen peer support among themselves.

Connecting care-givers, whether physically, or even through mobile chat groups, allows them to seek advice or share their own experiences with others, including the government and service providers, more effectively. For example, after meeting Minister Desmond Lee at the Care-givers Pod last year, a group of 15 care-givers came together and proposed a list of priorities that are most needed by care-givers. So, we welcome such ground-up intiatives and we are looking into how we can work together with them to address their concerns through customised solutions.

We are also aware that care-givers, especially older care-givers, worry about care arrangements for their children with special needs after they themselves have passed on. To address this concern, the Special Needs Trust Company (SNTC) was set up in 2008 to provide trust management services for these families. We also set up the Special Needs Saving Scheme in 2012 to enable parents to set aside CPF for the long-term care of their children. We will continue to explore more avenues and schemes to help address such concerns.

MSF is constantly looking at how we can improve the services we offer to care-givers. I therefore thank the Members for sharing with us their accounts of the struggles that care-givers in their constituencies face in seeking assistance from Government. Indeed, as pointed out by Ms Denise Phua, these are complex cases for which there are no one-size-fits-all solutions, or in her words, cookie-cutter policies, to address each individual issue.

While Government must do better to ensure that care-givers in need of help do not fall through the gaps, I thank Ms Denise Phua for also recognising that Government alone cannot resolve all the issues, and that we need to involve the wider community to support the needy in our midst. That said, MSF plans to strengthen case coordination and management to provide better social assistance in cases of complex needs. We will share more about these plans at the Committee of Supply this year.

Sir, to do good work together, Government must engage stakeholders, and be open to their feedback and work with them. For example, the EMP3 steering committee called for improved access to information on disability-related social support and services, and suggested creating a one-stop information portal for care-givers to meet their needs for information on services, care-giving, self-care and well-being. To answer this call, SG Enable is developing a new online portal that will act as a 24/7 information hub pointing care-givers to social support available for their care recipients and also for themselves.

We also heard from VWOs that run Special Education schools, that parents feel overwhelmed with options when deciding which care service would best suit their child who is about to graduate at age 18. So now, we are working closely with MOE to improve the transition management process, to help parents make an informed decision on the appropriate care service for their child.

Sir, many care-givers have also expressed concerns over the future of their children, especially after they leave school. Parents know that they will not always be able to take care of their children, and they hope that their children will be able to find and hold on to good jobs, and live independently despite their special needs.

We understand all these hopes and concerns, and want to assure them that MSF is committed to meeting the employment needs and enhancing the independent living prospects of persons with special needs. Our "Future Economy" and "Smart Nation" drive will not leave their children behind, but rather, be enablers for greater inclusion both in the workforce and also in the community. As part of our efforts to engage the community, to co-design and co-create solutions, we are examining these issues together with persons with special needs, their care-givers, government agencies, VWOs and other stakeholders. MSF will elaborate on all these plans at the Committee of Supply.

Now, let me touch on the topic of helping more Singaporeans make a Lasting Power of Attorney (LPA) which some Members, including Miss Cheryl Chan, have raised. The chances of losing mental capacity increase as we age. As individuals, we can plan early to appoint a family member to make decisions for us when we lose mental capacity. This advance planning will give our care-givers clarity and peace of mind.

Making a LPA is, therefore, very critical, and MSF will continue to encourage more Singaporeans to do so. In the process, we have simplified the LPA application process and extended the LPA fee waiver of $75 to 31 August 2020. To raise awareness, we recently launched a radio campaign in January, to encourage more Singaporeans to make an LPA. We have also partnered other agencies to hold public education talks. For example, we worked with HDB to inform Singaporeans on LPAs at HDB's series of Heartland Talks. We will continue with these public education efforts.

The number of LPA registrations have also risen in recent years, almost doubling from around 12,000 LPAs registered in 2017, to around 23,000 registered last year. This is very encouraging. Miss Cheryl Chan has suggested using HDB flat transactions as a touchpoint for even more simplified LPA-making. We will certainly look into this suggestion as we continue to explore how we can make it easier for people to make an LPA.

In closing, Sir, I thank my MOH colleagues for putting together the Care-giver Action Plan, as well as the care-givers and community partners who step forward to provide feedback during the consultations. The plans are an important step in the right direction, as pointed out by Members of this House. I believe that together with the support and partnership of the people, private and public sectors, we can build a more inclusive society for all. Mr Speaker, Sir, I support both Motions.

5.56 pm

The Senior Parliamentary Secretary to the Minister for National Development (Ms Sun Xueling): Mr Speaker, Members have made many useful points about how we can help our seniors to Age with Purpose. It is not surprising that housing and the design of our urban environment is close to the hearts of many, given that it affects the daily lived experience of all Singaporeans.

Ms Rahayu Mahzam spoke about how we could build more facilities, such as toilets and benches near to senior fitness corners and parks, to encourage seniors to exercise more frequently. Our parks are enjoyed by families, groups of friends and Singaporeans of all ages. All of them have benches and resting spots which seniors may use. In addition, toilets and shelters have been installed in our bigger and more frequented parks, such as our national gardens, regional parks, and nature parks.

NParks has been upgrading our green spaces to encourage seniors to age not only actively, but also comfortably and safely. These efforts include incorporating new senior-friendly amenities such as fitness corners, shelters, toilets, and footpaths; replacing metal drain covers next to footpaths to minimise the risk of seniors tripping and falling over; and also improving lighting in parks.

NParks has made good progress on these initiatives, and will continue to enhance efforts in this area. For instance, by FY2019, we will have introduced 48 senior-friendly fitness corners and 17 shelters, as well as finished enhancements at various parks. By FY2020, we will have added 19 new toilets to various parks and park connectors. We will continue to review the provision of senior-friendly facilities in our parks.

Apart from parks, we agree with Dr Lily Neo and Ms Tin Pei Ling that it is important to consciously design our housing estates and buildings to be senior-friendly. Since 2006, all new HDB estates have incorporated Universal Design features. For instance, building common spaces with ramps instead of steps, having barrier-free routes to connect various amenities, having more seating in common spaces, and mounting letter boxes at comfortable heights.

Within the flats, lever door handles and rocker switches are mounted at lower heights, and we have widened corridors and doorways to allow for better wheelchair manoeuvrability. Our short lease 2-room Flexi flats which are meant for seniors also come fitted upfront with grab bars. Under the Optional Component Scheme, seniors may choose to have their flats come complete with a wardrobe, kitchen hobs and cabinets. These come with elderly-friendly features such as lower clothes hanging rods for easy reach, and wheels on the bottom of kitchen cabinets so they may be rearranged easily. In addition, seniors can opt for lower kitchen countertops and cabinets, especially for wheelchair users.

To better facilitate smart systems such as monitoring systems for elderly care, HDB is piloting smart-enabled homes in Punggol's Northshore district. These homes will be equipped with additional infrastructure, such as additional power and data points, to support the easy installation of smart systems within the flat. We expect these flats to be completed next year.

For existing blocks, Members will also be familiar with the various upgrading programmes in your respective neighbourhoods, such as EASE which provides senior-friendly features. Members are also welcome to play a role in adapting the estate to the needs of elderly residents. For instance, Town Councils can add more benches and ramps by tapping on our various upgrading programmes. While HDB communal areas are typically not provisioned with toilets as they are located near the resident’s homes, neighbourhood centres or eating establishments so that seniors can have ready access to toilet facilities. Nonetheless, should there be demand for public toilets at specific locations in selected precincts where there is an ongoing Neighbourhood Renewal Programme (NRP), Members can highlight the request under the NRP. HDB will assess these requests on a case-by-case basis.

Dr Teo Ho Pin raised the issue of funding caps for CIPC projects. While there are caps in place for items on the CIPC menu, these are meant to ensure prudent use of Government monies. Nonetheless, we can assess requests on a case-by-case basis.

Beyond just housing estates, we also carefully consider how buildings can be thoughtfully designed to cater to all elderly users and workers. We agree with Mr Zainal Sapari that it is important to provide adequate rest areas for our elderly workers and we will work with the other agencies to look into the Member's suggestions.

Ms Joan Pereira suggested building more blocks of integrated housing, similar to Kampung Admiralty. Indeed, Kampung Admiralty has been lauded as a model to be emulated, clinching the World Building of the Year award at the 2018 World Architecture Festival.

In Kampung Admiralty, HDB advanced the concept of being senior-friendly by building a whole development with senior residents in mind, and integrating their housing with healthcare, wellness and eldercare facilities.They also included a childcare centre, shops and eateries that bring the different generations together. It is, as Prime Minister said in the National Day message last year, a "high-rise kampung where residents are out and about, socialising with family, friends and neighbours, and yet never too far from home".

We will look to do more of such integrated developments, where there are suitable sites. However, not all seniors may wish to move out of their current residence, as many may prefer to age-in-place.

Therefore, the Government's strategy is also to retrofit existing HDB estates to make them senior-friendly. We will make sure that there is a good range of socio-communal facilities such as eldercare and childcare centres, so our seniors have good access to the provision of various services, wherever they may be staying.

Members have also suggested having Group Homes and Assisted Living services for seniors in our public housing, which Senior Minister of State Amy Khor has responded to. We will share more details at the upcoming Committee of Supply debate.

As for the private sector, MND, MOH and URA agree with Ms Rahayu Mahzam that there is increasing need for more diverse housing options for seniors, particularly those that twin housing and care services, to better allow able seniors to meaningfully age in place. Developers and senior care operators have indeed shown interest in providing retirement housing concepts in Singapore. Agencies have been working with them to study and facilitate suitable retirement housing typologies in the private market, that will work for our local context.

Taking the lessons from the Jalan Jurong Kechil development, one area that we are keenly studying is how best to ensure future retirement housing products in the private market properly cater to their intended demographic, by introducing appropriate controls. We will share more details in due course.

The regulations are just one aspect. It is also important that the private sector also study the provision of assisted living services to cater to this segment, so that Retirement Housing products can be more meaningful and attractive for seniors in the long-term. These findings will help shape and regulate the development of the private retirement housing market going forward.

Mr Henry Kwek also touched on how we could facilitate and strengthen family support for our seniors. MND recognises the role that housing can play in encouraging mutual care and support among family members, whether it is through introducing flat typologies that are suitable for multi-generational living, such as our 3Gen flats; or helping families to live together or close to one another, through our various grants and schemes. For instance, priority schemes, such as the Married Child Priority Scheme (MCPS), the Multi-Generational Priority Scheme and the Senior Priority Scheme, which give flat buyers priority when applying for a new flat with HDB with or near their parents or married children. And we also have the Proximity Housing Grant (PHG) which was only just enhanced last year. Those who purchase a resale flat to live with their parents/children can enjoy a PHG of up to $30,000, while those buying a resale flat to live near their parents/children can enjoy a PHG of up to $20,000.

Over the years, our public rental flats have played an important role in helping our most vulnerable seniors who face difficulties in securing a roof over their heads. Singles currently apply for public rental under the Joint Singles Scheme, and share a flat. Miss Cheryl Chan suggested allowing those with health conditions to live alone. For those with medical conditions that make it difficult to flat-share, HDB already allows them to rent alone if they have a doctor's recommendation to do so. And, separately, since 2015, HDB has made available some new 1-room rental flats with partitions to create separate sleeping areas for each occupant. Almost 500 of such flats have been completed, and another about 200 are under construction. We will explore how to make more partitioned flats available to Joint Singles.

Miss Cheryl Chan also suggested further fine-tuning the criteria for other groups who may need rental flats. For seniors with serious illnesses who monetised their homes to fund their treatment, HDB considers their medical conditions and expenses if they appeal for public rental, and exercises flexibility based on their individual circumstances.

Seniors whose family relations have broken down but still own a flat can seek help from Family Service Centres, which would facilitate family reconciliation, and coordinate support for the seniors’ other needs. This is important as the senior still has rights to his or her property. If the senior is in urgent housing need in the interim, MSF and HDB will work together to provide accommodation for the senior.

Ms Rahayu Mahzam also spoke about having more flexibility and compassion in assessing applicants' eligibility for various schemes. As the Member has noted, we do exercise flexibility based on the circumstance of each case but we will be happy to engage the Member on this specific case and assist the resident where needed.

Let me now address Miss Cheryl Chan's suggestion to allow more flexible usage of CPF OA monies for older HDB flats. We agree that more can be done to provide flexibility for buyers of shorter lease flats, while still safeguarding their retirement adequacy. We are working with the CPF Board to review and update the CPF rules for the purchase of older flats and will announce them once the details are ready.

Miss Chan also spoke about seniors having to top up their Retirement Account (RA) in order to qualify for the Lease Buyback Scheme (LBS). The LBS allows seniors to monetise their flat for their retirement needs, while continuing to live in it. As such, the LBS proceeds are first used to meet members' CPF retirement needs. And this ensures that seniors are able to benefit from a lifelong income stream under CPF LIFE. Any remaining amount can then be taken out in cash.

In conclusion, Mr Speaker, our seniors are a treasured part of our Singapore society, and we will do our best to help them age actively, and retire gracefully in our housing estates and public spaces. We will be looking forward to share more details of our plans at the upcoming Committee of Supply debates. On this note, Mr Speaker, I support both Motions.

6.09 pm

The Senior Parliamentary Secretary to the Minister for Manpower (Ms Low Yen Ling): Mr Speaker, Sir, I would like to thank the Members for their views on the two Motions.

A year ago, this House discussed a Motion on Support for Senior Citizens, which called on the Government to spearhead community efforts and strengthen support for seniors to thrive and age with dignity. The two Motions today continue to uphold the spirit of last year's Motion, and underscore the importance of supporting older Singaporeans' work aspirations and also their role as care-givers.

Our nation's fast-ageing population, longer life expectancy and low birth rates are recasting the roles that older workers will play in our economy. And, in the last one year, I have spoken to many employers. Many employers are looking at how older workers can be a crucial solution to their manpower needs, and our seniors are rising to the challenge.

We are already seeing this bear out in our employment numbers and trends. The employment rate of residents aged 55 to 64 rose from 57% in 2008 to 67% in 2018, an increase of 10 percentage points. This ranks us 11th as compared to other OECD countries, above the United Kingdom, Australia and the United States.

Supporting and empowering older workers continue to be our key priority. The rise in older worker employment has come about due to the close partnership and efforts of tripartite partners. Many of the Members spoke about – tripartite partners working together to raise the retirement and re-employment age. This was done through careful deliberations over the years and is part of the "whole of Singapore effort" to address our demographic challenges.

Dr Intan asked to raise the retirement and re-employment ages further. The tripartite workgroup on older workers is studying this, amongst other issues.

Besides legislation, the Government has also invested significant resources to provide funding and transformative support for older Singaporeans and their employers that help them adjust and stay relevant. For example, employers hiring older workers receive wage offsets of up to 11% of their monthly wages via the Special Employment Credit (SEC), as well as training and salary support for employing mature PMETs. The amount of Workfare payouts, which supplements the income of lower-income workers, is higher for older workers.

We have also provided extensive support for seniors to reskill and upskill, so that they can continue to contribute in the workplace. For instance, the SkillsFuture Mid-Career Enhanced Subsidy offers additional subsidies for older workers enrolling in courses pre-approved by MOE and SkillsFuture Singapore (SSG). The measures that I have mentioned encourage and support employers to send their older workers for training, as Mr Patrick Tay has urged earlier. Seniors can also advance their own skills and training by using their SkillsFuture Credits. They can choose from many courses, like those offered by the Silver Infocomm Junctions to equip them with basic digital knowledge. These skills can facilitate their entry into the platform economy and possible freelance opportunities, as suggested by Mr Henry Kwek earlier.

In addition to direct monetary support, I agree with Mr Henry Kwek, Ms Rahayu Mahzam, Mr Zainal Sapari and Dr Teo Ho Pin that we need more companies to take concrete actions in redesigning jobs and improving the working environment for our older workers. The Workpro Age Management Grant and Job Redesign Grant help employers implement age-friendly practices and restructure jobs to make them easier, safer and smarter for mature employees. This not only benefits the seniors, but also win-win for companies, as they stand to gain from the rich experiences and expertise of an older workforce.

Smarte Carte, which supports Changi Airport's operations, is one such company. I am impressed that over half of their 300-strong workforce is made up of older workers. I asked them and they told me their average age of its employees is 65 years old. The average age of their 300 employees is 65 years old. There is no compulsory retirement and its staff can enjoy the same pay even after they turn 62 years old. Their oldest employees are trolley service officers Mr Ng Kay Keng and Mr Tan Siak Hwee, who are both 83 years young. They have been with Smarte Carte for four-and-a-half years now and they like the company's age-friendly practices. And I tell you, Smart Carte really put in the efforts to make it very senior-friendly. They redesign work processes for its mature workers and they use mainly diagrams and videos to train the seniors in bite-sized sessions for easy learning. Supervisors also tailor their pre-shift briefings to reinforce processes and key messages that are important for our older workers' safety and security.

To better support older workers at work, Mr Patrick Tay and Mr Ang Wei Neng have asked about the Special Employment Credit and WorkPro schemes to be enhanced and extended. I want to assure them that MOM is currently reviewing the schemes and will certainly share more details when the information is ready.

Our efforts do not stop here. We recognise that as more Singaporeans grow older, and we all will get there someday. Some of us, like Speaker had mentioned earlier, are members of the Merdeka Generation. So, there needs to be adjustments to new work aspirations, retirement and care plans. The Minister for Manpower Mrs Josephine Teo announced the formation of the Tripartite Workgroup (TWG) on Older Workers mid last year. The TWG on older workers was tasked to study key issues such as the retirement and re-employment age as well as CPF contribution rates for older workers. In the last eight months, we have gathered the feedback and input of more than 500 people – older and younger workers, union leaders, HR professionals, SME employers, Trade Associations, Industry Associations and various stakeholders.

The exercise revealed diverse wishes that need to be balanced against the needs and expectations of different stakeholders. For instance, while older workers desire to work for as long as they can and are able to, younger workers share with us that they do worry about how that may affect their career progression. Or while employers may want to retain their older workers, these employees may not want to continue at the same intensity as before. For example, they may want to spend more time with their grandchildren, or pursue certain aspirations that they have always wanted to, due to their changing life goals.

All of these views gathered over the last eight months are valuable and important. And I want to assure Members, and also Mr Patrick Tay and Mr Faisal Manap, that it is the aim of the TWG to work towards a balanced win-win outcome. We need to strike a healthy balance between meeting the aspirations of our older and younger workers, the need for organisational renewal, redesign jobs – as many Members have spoken about – and how wages and benefits can be flexibly adjusted. So that Singapore can continue to retain our attractiveness as a business and also investment location.

Beyond supporting our older workforce, we also recognise the care-giving needs that have emerged with our ageing population. Many Members have spoken about it over the last three hours. We understand that more Singaporeans are having to balance their work with care-giving responsibilities they shoulder for their dependents and loved ones. And we want to assure Members, including Dr Lily Neo, Dr Chia Shi-Lu, Mr Christopher de Souza, Mr Melvin Yong, Ms Rahayu Mahzam, Mr Chen Show Mao and Ms Tin Pei Ling that MOM and also our tripartite partners are strongly committed to provide care-givers with the necessary workplace support so that they can fulfil their work and personal responsibilities and commitments including their care-giving commitments.

To better understand the needs of care-givers, MOH Senior Minister of State Edwin Tong led a cross-agency review and engaged stakeholders including employers and care-givers. The working care-givers whom we interviewed indicated that Flexible Work Arrangements (FWAs), and Senior Minister of State Edwin Tong spoke about it, would be a sustainable solution to help them balance their work and care-giving commitments.

As Mr Henry Kwek and Dr Lily Neo pointed out, employers also have an interest to support employees' FWA needs. Based on MOM's 2018 Conditions of Employment Report, it was found that among the various workplace practices, the provision of FWAs had the greatest impact on staff retention. So, a talent choosing to join company A, B, FWA features heavily in their consideration choosing which company to take up. Through the concerted efforts of the tripartite partners, Members including Ms Joan Pereira, Mr Melvin Yong, Mr Christopher de Souza and Ms Rahayu Mahzam will be pleased to know that as compared to five years ago, more workplaces are now supportive of FWAs. The proportion of companies in Singapore offering at least one ad hoc FWA has increased from 68% in 2013 to 84% in 2018. Those offering at least one formal FWA also rose from 44% in 2013 to 53% in 2018.

Across the sectors, more companies are providing a greater variety of FWAs as they recognise that workers have varying FWA needs at different stages of their lives. A worker may never know when they will need FWA. In particular, if they have to care for ageing parents, parents-in-law or even younger kids. It gives them a peace of mind knowing that if they put in a request, the company will provide. Last year, about 23% of the companies here offer at least two formal FWAs and that is up from 12% in 2013.

Besides their wish for FWAs, working care-givers also expressed their need to be able to take time-off whenever necessary, to care for their dependents and loved ones. I am glad to note that there has been progress on this front. Eighty-one percent of the companies in Singapore currently offer unplanned time-off, and this is a marked increase from 67% five years ago.

Dr Lily Neo, Dr Chia Shi-Lu and Mr Christopher de Souza have called for legislating care-givers' leave. Senior Minister of State Edwin Tong earlier, spoke about it as well. While we understand the reasons for this suggestion, the care-givers from our recent engagement tell us that their key requirement is not so much as to have one or two more days of leave, but to have the flexibility and ability to take some time off when the urgent need arises. Tripartite partners had also pointed out that having more legislated leave on top of the existing leave provisions could add cost to businesses, and this could inadvertently affect the employability of those with care-giving responsibilities. To this end, it is our priority to encourage employers to provide more FWAs to meet their employees' non-work needs.

Employers who do so with understanding and care really stand to gain from the improved loyalty and productivity of their staff. Take the example of Angilay Davy, who is also known as Angie, a 60-year-old full-time trainer with aAdvantage Consulting Group. Angie is the primary care-giver to her elderly sister. This is quite similar to many of the profiles that we have shared in the last three hours. She has to bring her sister to hospital appointments regularly. To support Angie in her care-giving duties, aAdvantage lets her have the flexibility to work from home and to take a few hours off work, when necessary. Her co-workers support her by covering her work when she is unable to attend client meetings or conduct trainings due to her care-giving duties. This company conducts a lot of trainings for their clients.

Such a FWA is a win-win for both employer and employee. aAdvantage is able to retain valuable employees like Angie and in Angie, many other employees also see this as an organisation that cares. So, it really inspires, not just in Angie, but the rest of the staff they have in the organisation. They manage to retain valuable employees like Angie, who is an asset with her many years of experience. Care-givers like Angie can continue to be a productive employee, while meeting the care needs of her sister.

We have talked quite a bit about FWA. We recognise that FWAs are not one-off solutions but they are really long-term practices sustained by a supportive workplace culture. MOM recently extended and enhanced the Work-Life Grant for companies. This scheme allows each company to receive up to $105,000 over two years, to help the company maintain their employees' flexible working arrangements on a regular basis – whether it is flexi-time, flexi-load and flexi-place. I agree with Dr Chia Shi-Lu that schemes must not be onerous administratively, such that it deters adoption. Therefore, the Work-Life Grant was recently enhanced to make it easier for the employers to qualify. Since its launch, the Work-Life Grant has received more than 340 applications in five months.

To enable more companies to benefit from the Work-Life Grant and to make FWA adoption more pervasive, MOM is exploring to increase the Work-Life Grant budget. More details will be shared at the MOM Committee of Supply next month. We will also continue to encourage more companies to adopt the relevant Tripartite Standards and publicly commit to progressive workplace practices. As at December 2018, about 1,200 employers hiring 380,000 workers have adopted the Tripartite Standard on FWAs, while some 430 employers hiring 220,000 workers have adopted the Tripartite Standard on Unpaid Leave for Unexpected Care Needs. I agree with Dr Lily Neo that Government agencies should take the lead, and I am pleased to share that adopters of the Tripartite Standards include those in the public sector.

Our efforts to promote the adoption of FWAs are showing positive effects. Mr Henry Kwek suggested studying and learning from FWA legislation of other countries to promote greater FWA adoption. We will need to examine the potential impact and effectiveness of any FWA legislation before considering a model which is suitable for Singapore. Having a legislated right to request FWA may not necessarily improve adoption of FWAs if companies are not able to restructure their jobs or workplace arrangements to accede to the FWA requests. It may well backfire. The key is to better support and enable the companies. We are mindful that FWAs could affect business operations and we would not want to inadvertently affect the employability of the staff who are requesting for FWAs.

FWAs help working care-givers juggle their work and care-giving responsibilities. However, depending on the level of care required by their loved ones, some care-givers may leave the workforce temporarily or even longer periods. Many of our Members have cited examples in your ward. Those who have been away for a long period of time, may need additional help to find jobs but they may not be familiar with the existing employment support they can get.

We will raise greater awareness of the Adapt and Grow initiative that offers a suite of services and programmes to facilitate employment matching and help jobseekers overcome mismatches in skills, wages or job expectations. I want to assure Members and also Mr Melvin Yong that MOM and MOH will in the second half of 2019, be reaching out to care-givers who wish to return to the workforce. We will do so through various touchpoints such as AICare Links operated by the Agency for Integrated Care.

Dr Intan asked to raise the CPF contribution rate for members age 55 years old and above. The TWG on Older Workers is currently studying the CPF contribution rates for members aged 55 and above. For self-employed persons (SEPs), we are going to make it easier for them to make MediSave contributions by implementing a "contribute-as-you-earn" model. The Government, as a service buyer, will take the lead to pilot this with our self-employed contractors. After addressing the challenges, the SEPs face with MediSave contributions, we will then review how SEPs can also contribute to their CPF Special Account.

Members, including Mr Henry Kwek, Mr Chen Show Mao and Ms Anthea Ong, have voiced their concerns about improving the retirement adequacy of care-givers. We recognise that some full-time care-givers may not have been able to work in their younger years. They may therefore not have much CPF savings for retirement. This is where the Silver Support Scheme can come in. Silver Support Scheme supplements the retirement incomes of elderly Singaporeans who had low earnings throughout their lives and currently have little or no family support. In 2018, over 153,000 elderly persons received Silver Support payouts amounting to $335 million.

For those with family members who can top up their CPF savings, the Government has lowered the minimum threshold sum required to make it easier for CPF members to transfer their CPF savings to their spouses, parents and grandparents. This will enable more members to strengthen their retirement adequacy of their loved ones.

We are encouraged by the positive response to this move. Last year, a total of 3,200 members benefited from CPF transfers from their spouses, while a total of about 2,800 members received CPF transfers from their children and grandchildren.

Assoc Prof Walter Theseira made three suggestions: first, he proposed to strengthen Silver Support Scheme; second, he suggested topping up the CPF accounts of members with low contributions; and finally, he asked for the Lifetime Retirement Investment Scheme (LRIS) to be introduced soon.

First, we are concerned about elderly who may not have enough retirement income. However, it is also important to place this in context. The vast majority of our elderly own their own homes and have family support and personal savings to rely on. Attainment on Basic Retirement Sum (BRS) has been improving steadily with about 70% of active members being expected to attain BRS at the age of 55 by Year 2020. For those with lower income throughout their lives, and have little or no family support in retirement, we have, as I said earlier, Silver Support Scheme to supplement their retirement incomes. And I want to assure Assoc Prof Walter Theseira we will review Silver Support Scheme from time to time to ensure that it continues to provide meaningful support for this group of elderly. At the same time, we have to balance this with the need to ensure that the entire system remains fiscally sustainable in the long run.

Second, we already supplement CPF contributions of the lower income via the Workfare Income Supplement (WIS) Scheme. We have taken this approach because, as a society, we want to encourage work and employment and, earlier on, we heard from many Members that many of the seniors that you spoke to, they want to work for various reasons: financial independence, for passion, for purpose. I remember Mr Patrick Tay spoke about the example that he mentioned "he wants to work because it allows him to be physically and mentally sharp". So, as a society, we embrace this and we have uplifted the wages of the lower income and kept employment high and then unemployment low. For those unable to help themselves for various reasons, we want to make sure a safety net is there to support them. We want to make sure that those who cannot work and have no support, the Government will provide for their basic needs and, if necessary, give them the long-term support. And this is where the whole-of-Government will have to step in: MOM, MSF and Members have heard from MND Senior Parliamentary Secretary Sun Xueling as well.

Third, CPF interest rates are already high compared to other market instruments on a risk-adjusted basis. I want to assure Assoc Prof Walter Theseira that we are studying LRIS carefully. Now, however, developing an investment product, especially as you can see what happened in the last 10 years with investment products, especially, sophisticated one, developing an investment product is a complex effort and we have to carefully balance the risks as undertaken by our members and the expected returns. So, we want to assure Assoc Prof Walter Theseira that we certainly will update on LRIS in due course. So, overall, we have a system that strikes a balance between adequacy in retirement, support for the lower income seniors, especially, those who have low balances in their CPF accounts and also longer term fiscal sustainability and we have achieved good results in retirement adequacy with comparable replacement rates to other OECD countries. While we are constantly looking for ways to do better, we should build on what has been working well for Singapore and Singaporeans.

Now, talking about CPF, we have also been going out there to get feedback from members and we recognise that some people may find the different CPF schemes and requirements fairly mind-boggling. In 2015, we introduced a one-on-one, personalised CPF Retirement Planning Service (CRPS) to help older workers better understand the various CPF schemes and make their plans before they turn 55 years old. Last year, we expanded CRPS to include options such as the Silver Housing Bonus, which lets the members unlock the value of their HDB flats and boost their retirement payouts. This year, the CRPS is available to those turning 65 years old. As Mr Henry Kwek suggested earlier, we will also work with community partners to provide services that help older Singaporeans plan for their financial milestones and better prepare for retirement.

So, Mr Speaker, Sir, indeed, a whole-of-society effort is necessary for Singaporeans to age with purpose, to age with dignity. Increasingly continued employment is becoming a key aspiration of ageing meaningfully. It is our common goal to support our seniors so that our seniors can continue to contribute to the economy, continue to contribute to the community for as long as they are able to and they wish to. We will do all we can to make our workplace supportive of Singaporeans who need to balance care-giving responsibilities alongside their work.

I want to assure Members that there will be no let-up in MOM's efforts to foster age-friendly and progressive work practices among employers. "Age-smart" companies stand to gain when they start thinking about creating alternative career routes for older workers and also providing more flexible work arrangement and schedules for them. And by creating opportunities for our senior workers to mentor the younger workers, these "age-smart" companies can enjoy the best of "both worlds" and also enjoy health age diversity which, according to many research articles, will also improve productivity. This not only helps them to attract and retain talent, it also encourages the employees to adopt the mindset of continuous upskilling to remain employable and to remain productive.

So, together, we can age purposefully in a caring society where work and family have a place, and where our responsibilities and our aspirations are met as we strive to support one another. So, on this note, Mr Speaker, Sir, I support both Motions.

6.37 pm

The Senior Minister of State for Culture, Community and Youth and Trade and Industry (Ms Sim Ann): Mr Speaker, Sir, MCCY believes that our seniors' golden years should be fulfilling ones, where seniors can continue to pursue their aspirations and also give back to society. We agree with the suggestions made by many hon Members that seniors should be involved in the wider community, be it through volunteerism, sports or the arts.

Our seniors may have transited out of the workforce, but they continue to have much to offer due to their wealth of life experiences and skillsets. Through volunteerism, seniors can also reap benefits such as sustained social and mental wellness. At the same time, they will serve as inspirations and role models for future generations, and strengthen our society through norms and values.

According to the National Volunteer and Philanthropy Centre's (NVPC) Individual Giving Surveys, volunteerism rate among those 50 years and older has been growing steadily over the years – from 13% in 2008, to 29% in 2016. In fact, our seniors have been shown to be far more avid and consistent at volunteering than younger age groups!

We agree with the recommendation made by Members to provide more support for seniors’ volunteer efforts. We will continue to grow partnerships with community partners to engage more seniors.

MCCY has already been working alongside a number of organisations that help match seniors to volunteering activities, according to their interests, availability and preferred locations. One such organisation is RSVP Singapore, which has been actively training and matching over 2,500 Silver volunteers for the past 20 years. We will continue to support RSVP and similar groups.

NVPC has been exploring partnerships with learning institutions and community organisations that run courses for older PMETs. Through such partnerships, older PMETs can be connected to volunteer opportunities where they can apply their newly acquired skills, such as community gardening or befriending.

As Mr Ang Wei Neng has raised, senior volunteers can provide valuable advisory services to VWOs. We agree that the Centre for Non-Profit Leadership's (CNPL) BoardMatch Programme is doing good work in reaching out to committed and highly qualified professionals across various industries and sectors and identifying candidates who are able to serve non-profit organisations in a leadership capacity. There are many opportunities for such volunteers to help with building up governance capabilities and bringing fresh perspectives to the non-profit sector.

Senior volunteerism is an integral part of the larger SG Cares movement where we want to grow care and inclusivity in Singapore. We hope to identify more champions from various walks of life, who can rally fellow seniors to serve in their communities.

We also support the recommendation to encourage seniors to take greater ownership of their health. We will continue to dedicate more resources to cater to their needs in the area of sport and exercise.

Beyond the ActiveSG Masters Programme mentioned in the report, we also have Active Health. It is a national social movement that goes beyond healthcare to health, to celebrate living.

To kick-start their journey, seniors can visit an Active Health Lab for a free onboarding session to assess their health status and fitness level. Active Health experts will then work with them to set personal health and wellness goals. Seniors can then get active by participating in programmes at our ActiveSG centres and Sport-in-Precinct facilities. To-date, two Labs have been opened at Our Tampines Hub and Heartbeat@Bedok, with another four more scheduled to be opened in Bishan, Jurong East, Sengkang and Woodlands by end-March 2019. There are also Active Health Mobile Labs deployed across the island for those who do not live near an Active Health Lab.

Living better through sport is not limited to physical activities. It includes community roles for seniors,who can sign up to be Team Nila volunteers at the ActiveSG centres. They can serve as sport or Active Health champions, where they have opportunities to meet like-minded volunteers while they galvanise the community to get active.

MCCY is also working with SportSG to ensure that our sporting spaces are designed to cater to our seniors. For example, at the upcoming ActiveSG gym in Ang Mo Kio Community Centre, seniors can participate in elder-friendly exercise programmes when it opens later this year. We will make sure all our ActiveSG gyms provide an environment that is safe and accessible for our active agers, and furnished with equipment that is suitable for their usage. There will also be qualified staff on-site to provide any assistance.

It is important to involve our seniors in our arts and heritage too. This can improve their quality of life, while enriching our cultural offerings. As pointed out by Mr Terence Ho, the arts can play an important role in building social bonds and increasing mental well-being as we age. MCCY, NAC and NHB are working very closely with the arts community, and other partners from the social service and healthcare sectors, on programmes that are accessible and relevant to our seniors.

For instance, NAC has organised an annual Silver Arts Festival since 2012 to showcase the creativity of our seniors and promote inter-generational bonding. The 2018 Festival featured a community arts project between youths and seniors from NTUC Health Active Ageing Hub at Kampung Admiralty, which included an installation and performance on the theme of "happiness". In addition, our Heritage Institutions serve as Silver Hubs to promote active ageing. For example, seniors and their families, friends and care-givers can engage one another through a Conversation Starter Kit co-developed by NHB and the National Council of Social Services, Care Corner, SAGE Counselling Centre, TOUCH Community Services, and Yong-En Care Centre. This kit includes images of significant landmarks and artefacts, prompting the exchange of personal memories and inter-generational dialogues.

MCCY, NAC and NHB will continue with these efforts. We want to ensure that our seniors have ample opportunities to participate in our arts and culture landscape. Sir, allow me to say a few words in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] Mr Speaker, Sir, Singapore's social structure is changing rapidly. As the average age of our population rises, MCCY will endeavour to help our seniors live an active, healthy, meaningful and fulfilling life.

We plan to create more opportunities and channels for seniors to participate in volunteer work, sports and arts activities. MCCY has been working alongside a number of organisations that help match seniors to volunteering activities according to their interests, availability and preferred locations. Arts and culture will not only help seniors to communicate more but also improve the quality of their lives. MCCY, NAC and NHB have been working with arts groups, social workers and healthcare organisations to launch arts activities suitable for seniors so that they can enjoy their golden years.

Of course, having good health is also very important. MCCY and Singapore Sports Council have been working together to build more elderly-friendly sports facilities. In particular, gymnasiums managed by the Council will progressively install exercise equipment suitable for seniors to help them stay active and fit.

(In English): Let me now conclude in English, Mr Speaker. Many of our seniors want to continue making a positive impact to society, and remain active and connected throughout their silver years. We recognise that they have much to offer for future generations. Hence, we must support them as best as we can, and involve them in the community in ways that are meaningful and fulfilling. Mr Speaker, Sir, I support the Motions.

Mr Speaker: Are there any clarifications? Before I wrap up, I just want to share an observation. I think we have covered many details. They are all incredibly important because without good policies and effective implementation, nothing happens, but to what end? This is where I note that we use the "Merdeka Generation Package" quite regularly and I know that some of you are part of the Merdeka Generation. But I think it is instructive to remember that Merdeka means "freedom" and "independence". I think that is an aspiration that we are all inspiring towards, in the way we realise our older years as a nation.

With that, I will now call on Mr Henry Kwek to make his reply on his Motion on Ageing with Purpose followed by Dr Chia Shi-Lu for his reply on the Motion on Support for Care-givers. Thereafter, I will put the Question in respect of each Motion to the House for voting. Mr Henry Kwek.

6.46 pm

Mr Kwek Hian Chuan Henry: Mr Speaker, Sir, I thank all the Members who spoke today for supporting both Motions and for the 17 Members who spoke on the Motion on Ageing with Purpose. Your passion and thoughtful remarks are much appreciated.

Let me sum up the collective belief of our Members with regards to our Motion.

Today, we spoke about boldly reframing our narrative to a positive agenda, because while ageing brings a set of challenges, it also brings many exciting possibilities. In fact, Mr Mohamed Irshad mentioned that 70 is the new 60.

Also, given the diverse and evolving generations of and future seniors, we call for the Government to continue engaging and dialogue, especially through the spirit of our Singapore Conversation.

Members are also in agreement that most seniors find purpose through work, and bring much to the table. And according to Mr Patrick Tay, seniors are treasure troves of experience and expertise.

With regards to employment for seniors, Members note we are generally in a good position. Ms Rahayu Mahzam and I suggested adopting a sector-based, tripartite approach to create more full and part-time jobs, and to help seniors better access freelance opportunities.

Mr Patrick Tay suggested extending the Career Support Programme, especially since PMETs' unemployment and under-employment is a concern. He also suggested a top-up of the SkillsFuture Credit. Mr Zainal Sapari recommended employers adopt proper rest areas at worksites and environmentally-friendly equipment and technology so that work becomes safer and easier for seniors. Dr Intan Mokhtar asked to raise the retirement and re-employment age.

Beyond work, volunteerism is important. Our seniors, especially the Merdeka Generation, possess a wealth of knowledge and energy. Members, including Ms Joan Pereira and Er Dr Lee Bee Wah shared that many seniors want to contribute and not solely be beneficiaries. Ms Joan Pereira called for hospitals, museums, schools and VWOs to recruit more senior volunteers.

Members also asked both public and private organisations to help our seniors stay integrated with society.

Mr Terence Ho made compelling points about ageing well through the arts and asked for more support for the whole of Singapore for getting seniors to do art. Mayor Teo Ho Pin called for HPB to provide a dedicated endowment for CDCs to fund active ageing, so that this national movement has more legs.

Mr Ang Wei Neng suggested PA to take a harder look to explore more "work-based" activities that naturally attract more men, given that grassroots volunteers attract largely women. And Mr Mohamed Irshad called for more inter-generational bonding so that we can harness the collective wisdom of our seniors.

There is a saying that, "We shape the building, thereafter the building shapes us". Members spoke at length about housing and affordable assisted living services.

Dr Lily Neo spoke about not just the importance of affordable assisted living services, but also her own experience building such a service in Tanjong Pagar. Ms Joan Pereira spoke about Senior Activity Centres that should seniors beyond rental flat residents. Miss Cheryl Chan spoke about more flexibility for seniors to tap on CPF Retirement Accounts for housing so that they do not become cash-poor after selling their lease back to the Government. She also spoke about more flexibility in rental flat eligibility to help more seniors facing diverse needs, and putting in key aspects of the Lasting Power of Attorney and Will into our HDB processes. Ms Rahayu Mahzam spoke about having more group homes with assisted living facilities in both public and private housing, and more flexibility and compassion in assessing eligibility in our rental housing programmes.

In today’s debate, Members note that Singapore has undergone one of the most aggressive healthcare and healthcare financing system expansions and transformations in any developed country in recent memory and we can continue to build on that.

Therefore, Ms Rahayu asked MOH to exercise for more discretionary regarding CHAS eligibility to factor in changing income and family circumstances. Mr Melvin Yong asked for a review on funding model for nursing homes and cautioned against race to the bottom. Mr Darryl David asked for a whole of Singapore effort to active ageing and healthy living, a point that he made so passionately. Dr Intan Mokhtar spoke about encouraging more Singaporeans to practise medicine, especially to serve our seniors.

Members also spoke about making our transportation more senior friendly. Mr Faisal Manap asked for an update on the implementation of Silver Zones so that seniors can commute with a peace of mind. Miss Cheryl Chan asked for an innovative transportation mode in private estates for seniors, a point that I also agree on.

Members also spoke about the importance of individual responsibility. But as family nucleus continues to shrink, Ms Joan Pereira asked for holistic policy review, to remove obstacles for extended families to provide support for seniors should they choose to.

Members also discussed how to help seniors to be digitally ready. Ms Tin Pei Ling stressed the importance of designing to include. Mr Darryl David spoke about partnering with IHLs to promote digital literacy, and creating affordable senior-centric smartphones.

Members also spoke about seniors in need of financial support. Of course, in any society, there will be those who fall through the cracks. Therefore, Mr Faisal Manap also touched on the issue of elderly suicide, and asked for a closer look on this issue. He also questioned whether we can do more for frail seniors who feel compelled to work, doing tasks such as cardboard collecting.

And one of the ways to help seniors in need is to strengthen the retirement adequacy of seniors. Mr Ang Wei Neng, Dr Intan Mokhtar and myself spoke about gradually raising CPF for older workers to levels similar to that of younger workers, when the economic conditions allow for it. We note employers' concerns on raising cost, and the Government can help by not withdrawing their support for grants for older workers and senior retirees.

I also spoke about better incentives so that seniors can choose to defer their CPF payout withdrawals and also on the importance of strengthening financial literacy. Collectively, Mr Ang Wei Neng, Mr Patrick Tay and myself asked for an extension of the Special Employment Credit, the Silver Support Scheme and the Workfare Income Supplement. Assoc Prof Walter Theseira spoke about finetuning the CPF to provide a basic retirement payout, incentives to improve contribution rates and better returns on investment.

Beyond supporting our seniors in need through financial assistance, local programmes also help multiply and deepen the impact of Government policies. And Members today spoke at length on the various ways as leaders of this nation in various capacities, we collectively coordinate local efforts for seniors in need.

For me, this is the most inspiring part of our debate because needs express what words cannot. Mr Murali Pillai shared about how his volunteers assist care-givers to seniors with mental issues such as dementia. He also built up a team of health peers for residents.

A team from Kembangan-Chai Chee, where Speaker Tan serves, partners with AIC and IMH to also help families with mental illnesses. Speaker Tan also partners with VWOs to serve food to the nearly 450 needy families, 24/7, 365 days a year. In Henderson-Dawson, where Ms Joan Pereira serves, residents work with Willing Hearts to provide daily meals to neighbours in need, including many seniors.

Dr Lily Neo shared on how her grassroots rolled up their sleeves to create a social enterprise to provide affordable assisted living services to more than 500 of her residents. Mayor Teo shared on the very comprehensive programme that Northwest District has implemented to keep our seniors active and healthy. Er Dr Lee Bee Wah shared that in Nee Soon South, there are two cafes where seniors gather, and this makes it easy for VWOs to engage them. Nee Soon South also have a free volunteer-run aromatherapy and massage centre for care-givers, and is building a dementia-friendly community.

Mr Ang Wei Neng and Mayor Teo Ho Pin both shared that —

Mr Speaker: Order.

Debate resumed.

Mr Kwek Hian Chuan Henry: Thank you. And Mr Ang Wei Neng and Mayor Teo Ho Pin both shared that as chairpersons of their Town Council respectively, they took extra effort to take on older workers.

I shared Kebun Baru's comprehensive programme to take care of frail and socially isolated seniors, through befriending, medical attention, free-meal deliveries, healthy communal meals, and stepped up Police patrols. I also shared on our senior activity centre and church gathering points serving all seniors, our cancer peer support network and efforts to build a dementia-friendly Kebun Baru.

Now that I have summarised our discussion, let me thank Senior Minister of State Amy Khor, Senior Minister of State Sim Ann, Senior Minister of State Edwin Tong, Minister of State Sam Tan, Senior Parliamentary Secretary Low Yen Ling and Senior Parliamentary Secretary Sun Xueling for providing a comprehensive response on behalf of the Government and for taking on some ideas immediately.

In my conversations with Senior Minister of State Amy Khor, she frequently described our whole-of-the-Government plan for active ageing is a "Living Document", one with ample room for new good ideas. Indeed, her comment reflects the open-mindedness of our Government. I am confident that our Government will review our ideas closely, and take in many of them in good time.

At this juncture, I also like to thank retired Members of Parliament, Mdm Yu-Foo Yee Shoon, Assoc Prof Koo Tsai Kee and Dr Chiang Hai Ding, who in the best tradition of PAP.SG, passed down invaluable knowledge on senior policies from earlier generations of PAP Members of Parliament to current Members of Parliament, such as Ms Joan Pereira and myself.

Let me now wrap up the Motion. Indeed, to roll out the Merdeka Generation Package is a good opportunity for us to review our country's senior-related policies. The Merdeka Generation laid laid the foundations of the independent and modern Singapore with their can-do spirit and resilience. Now is a good time for Singapore to empower our Merdeka Generation and all our seniors to pursue an independent and active life in their golden years, filled with purpose and dignity.

Getting Singapore and Singaporeans prepared for successful ageing requires long-term planning. This is our strength and we must leverage on it. This requires us to develop the necessary policies and mindset beyond today and tomorrow.

PAP.SG believes that the Government can enact appropriate policies to address long-term ageing issues. But PAP.SG also believes that all of us wearing different hats, whether it is employers, employees, unions, social workers, and seniors, must all come together and play our role. No single group can succeed without the others moving together.

And ultimately, we must endeavour to be the best place in the world to age in place. Our seniors deserve nothing less. And one day, we ourselves will age, and we too deserve nothing less.

6.59 pm

Dr Chia Shi-Lu: Mr Speaker, it has been a long time and I would like to thank all hon Members who have participated in this debate and expressed their support for the Motion on Support for Care-givers, and also to the Government for their replies.

Clearly, it is neither sustainable, practicable nor desirable for all care-giving to be relegated to the state or to delegated institutions. This twin today Motion is united by a focus on the elderly, and caring for our seniors is an issue of particular relevance in the context of our rapidly ageing society. All Members agree that a whole-of-society approach is needed – all of us, the Government, the community, families and individuals need to work together to support our senior care recipients and also their care-givers, who are often elderly as well.

Care-givers face many hurdles, as Members have elaborated in some detail. But the one key problem that most care-givers face, and which has been described by many studies on care-givers, is financial. Many Members, Dr Lily Neo, Mr Chen Show Mao, Mr Christopher de Souza, Ms Tin Pei Ling, Mr Murali Pillai and also Dr Intan, agreed with me that the Government should look into providing a Care-giver Allowance of some form, in line with countries like Sweden, the United Kingdom, Australia and Hong Kong.

I am happy to hear that MOH will indeed be introducing such financial support in the form of a Home Care-giving Grant, as announced by Senior Minister of State Edwin Tong. I am also particularly happy that MOH will be allowing MediSave use to be extended to siblings, as this is not an uncommon appeal that I receive both as a doctor from my patients and also as a Member of Parliament from my residents. This would certainly help to alleviate the out-of-pocket expenditures of family care-givers.

The financial, and indeed the physical and mental, stress faced by care-givers is compounded by disruptions to their work due to their care-giving commitments, and, as noted, close to three-quarters of care-givers are employed. Mr Melvin Yong, Ms Joan Pereira, Ms Rahayu and myself have called for various means of workplace and workforce support. I am encouraged that MOM will be focusing on measures to facilitate flexible working hours, and considering enhancements to the Work-Life Grant.

Mr Melvin Yong has recommended a Progressive Wage Model (PWM) for professional care-givers and also asked for more to be done to support care-givers’ re-entry into the workforce. I believe that more can be done to leverage on schemes such as Adapt and Grow to support their re-entry into the workforce. Like Mr Yong, Mr Christopher de Souza and Dr Lily Neo, I also hope that MOM will re-consider legislating care-giver or eldercare leave for workers.

Today, in this House, we have heard many touching and inspirational stories of caring and being cared for, and your support for this Motion in this House today signifies your appreciation and recognition of the sacrifices and selflessness of all care-givers. And we have to do more to support care-givers, other than just financial support.

Many care-givers feel isolated and overwhelmed at various points in their care-giving journey and burn-out and depression are all too common amongst care-givers. Respite care is a critical component of caring for care-givers and more has to be done to make respite care in Singapore more accessible and more affordable, as noted by Ms Tin Pei Ling, Dr Lily Neo, Er Dr Lee Bee Wah and Mr Christopher de Souza. I welcome the announcements on the night respite care service for seniors with dementia and steps such as pre-enrolment to reduce onboarding times for respite services. The home-based respite service to support care-givers for cancer patients, as also announced by Senior Minister of State Edwin Tong, will also go a long way towards improving end-of-life care for Singaporeans.

AIC’s pilot outreach teams to reach out to care-givers who are themselves at risk, and the moves towards growing care-giver support networks in our neighbourhoods, are all welcome moves to safeguard the well-being of care-givers, and in turn those that they care for. I note, however, that the Survey on Informal Care-giving that was commissioned by MCYS and published in the early 2010s, noted that while recognising that support networks are likely to be important, the participation by care-givers in such networks was low and the overall experience reported was not particularly positive. I hope that we can learn from these past experiences such that the current incarnation of care-giver support networks will meet with greater acceptance and greater success.

Informal care-giving means that care-givers are typically not formally trained in care-giving, and often have their roles thrust upon them when a loved one falls ill, often quite unexpectedly. Many care-givers have shared that one of the reasons they feel unable to cope is because they have little experience and little knowledge about how to look after someone else in a proper and efficient manner. In a similar vein, we recognise that in Singapore a high proportion of informal care-giving is provided by Foreign Domestic Workers, who also often do not have such skills. Hence, the measures that were announced to broaden care-giver training are very welcome indeed.

Besides skills, many care-givers have also shared that they often had difficulties finding about formal support services that could have facilitated their care-giving duties. In hospitals, we have patient or care navigators to assist patients in accessing the types of care and support that they need, and this has paid significant dividends in improving the standard of patient care and the overall care experience, and improved value while reducing costs.

I am happy to learn that more effort will be put into improving care navigation for care-givers, and the leveraging of Silver Generation Offices for this purpose has also been suggested by Miss Cheng Li Hui, Ms Denise Phua and Mr Murali Pillai. E-services, as suggested by Mr Melvin Yong, can also be used to push out information to care-givers and assist care-givers to procure services and equipment. In a similar note, Ms Denise Phua has also spoken about the special challenges facing care-givers of Persons With Disabilities and a call for better case identification, individualisation and integration bears a closer look.

All of us here are care-givers, either at present, in the past or in the future. Caring for others is an important determinant of who we are as individuals, and who we are as a society. It is a duty that is often not anticipated and often unprepared for, but there is no nobler duty, particularly when we are caring for the elderly who cared for us when we were little and similarly vulnerable.

This Motion was raised to recognise this crucial role that care-givers play in society, particularly in regard to looking after our seniors, and we call upon the Government and all Singaporeans to continue our steadfast support for the care-givers amongst us. [Applause.]

7.06 pm

Mr Speaker: We have now come to the conclusion of the debate. I shall put the necessary questions to the House for a decision. We will first deal with Mr Kwek's Motion on Ageing with Purpose.

Question put, and agreed to.

Resolved, "That this House calls for a whole of Singapore effort to ensure that Singaporeans are able to age with purpose and dignity, stay healthy and connected, and be financially stable to look forward to their years ahead."

Mr Speaker: We now deal with Dr Chia's Motion on Support for Care-givers.

Question put, and agreed to.

Resolved, "That this House recognises, given our rapidly ageing population, the important role that care-givers play in helping our Singaporeans age with dignity, and calls on the Government and the community to continue strengthening support for care-givers."