Government Oversight of Care for the Intellectually Disabled

1 Dr Lily Neo asked the Minister for Social and Family Development (a) whether the Ministry identifies and closely supervises cases of intellectually disabled persons who have no familial support or are estranged from their families; and (b) what can be done to prevent such vulnerable persons from being taken advantage of or abused.

The Minister for Social and Family Development (Mr Desmond Lee): Mr Deputy Speaker, the Ministry for Social and Family Development (MSF) recognises the vulnerability of intellectually disabled persons who have no familial support. Some may not have mental capacity or may lose mental capacity for decision-making and judgement. MSF works with community partners such, as the Singapore Police Force (SPF), Social Service Offices (SSOs), Family Service Centres (FSCs), volunteer welfare organisations (VWOs) and disability services providers to identify and help persons with intellectual disabilities with no familial support.

Support for persons with disabilities, including those with intellectual disabilities, range from day care to long-term residential care. The starting point is to see how they can best be supported within the family and within the community. Some of these support services include the following:

(a) children disability homes, which are long-term residential care for children whose caregivers are incapable of caring for them, who have unsafe home environments and/or where their caregivers have passed on;

(b) drop-in disability programmes at Seniors Activity Centres, which provide social and recreational programmes for higher functioning persons with disabilities; and

(c) Day Activity Centres (DACs), which provide day programmes for persons with disabilities to enhance their independence by equipping them with daily and community living skills.

There are 29 DACs islandwide, and 19 cater to persons with intellectual disabilities. We have added another 400 DAC places in 2017 and will add more this year to increase the availability of such services to persons with disabilities. The wider community and public also have a crucial role to play in identifying and protecting these vulnerable individuals and to report any suspected violence or abuse. In this regard, MSF launched last year a three-year "Break the Silence" campaign to encourage bystanders and members of the public who witness or suspect violence to take action and to report. The campaign taps on social media, radio, television and roadshows to reach various segments in the community.

For persons who lack the mental capacity to make specific decisions relating to their personal welfare or property and affairs, a Deputy may be appointed under the Mental Capacity Act (MCA) as a proxy decision maker for that person. One of the key roles of the Public Guardian is to supervise Deputies appointed by the Court for persons who lack mental capacity, which include those with intellectual disabilities. The Public Guardian will also investigate whistleblower complaints on any alleged violation of the MCA provisions, including abuse or ill treatment of individuals without mental capacity, as well as instances of Deputies acting beyond the scope of the powers conferred on them by the Courts. If required, the Public Guardian will take appropriate action to safeguard such individuals, such as applying to the Courts to suspend or revoke an errant Deputy's appointment.

In some situations, persons with intellectual disability, regardless of mental capacity, may be unable to protect themselves from abuse or neglect. One of the additional levers to protect such individuals is the Vulnerable Adults Bill, which we hope to introduce in Parliament this year. The proposed legislation will allow the Government to protect individuals with physical and/or mental disabilities and who cannot protect themselves from abuse, neglect and self-neglect. This will complement existing laws that address violence, maltreatment and abuse against them.

Dr Lily Neo (Jalan Besar): May I ask the Minister whether there is a register for intellectually disabled people, so that they can be followed up with and assistance given to them should they require it? May I also ask the Minister whether MSF could have prevented the unfortunate circumstances that caused the death of Ms Annie Ee? Could she have been put under Public Assistance scheme where she could have received more assistance and need not have to stay with the people who abused her?

Mr Desmond Lee: I thank the Member for the follow-up questions. On the issue of register, we recognise that for persons with intellectual disability, it is a whole spectrum classified very, very broadly into "mild", "moderate" and "severe" intellectual disability. Many young people who are diagnosed with intellectual disability get support when they are in preschool and when they go to SPED schools, whether they are in special needs education or in mainstream schools.

In that regard, agencies, schools, the community know who they are. For those with more severe needs, FSCs, specialised centres, preschools and schools will refer them, especially after they have graduated, to support services such as DACs. For those with more severe needs, they will be referred to even institutional care, if required.

Caregivers are given the necessary support and grants to undertake training in order to better support family members with intellectual disability.

As for the horrific case of Ms Annie Ee, I would preface to say that it is a very sad case, which caught public attention and caused tremendous unhappiness at what happened to a young lady with intellectual disability who was out there, working and looking after herself. The case had recently been up for sentencing and because there is an opportunity for appeal, I would like to preface by saying I would not talk specifically about the case.

So, I will make general remarks about how as a community and as individuals and how as a network of Government agencies, FSCs and VWOs, we can work together to strengthen the support for persons with disabilities, including persons with intellectual disability.

In this particular instance, we are referring to a case of a person with intellectual disability who went out to work, went to find employment for herself, to look after herself. The importance of having legislation to protect such persons cannot be further emphasised. We have an existing set of laws in the Penal Code that allow us to take actions against abuses. The Vulnerable Persons Bill which we intend to introduce will allow us to intervene even behind closed doors, to reach out to families and to reach out behind families.

But none of these will be effectual unless family members, colleagues, neighbours and passers-by, people who interact and suspect something amiss is happening to not just persons with intellectual disability but to persons with disabilities, to children and to vulnerable adults, step forward, raise the alarm bell and bring their suspicions to the attention of the authorities.

Dr Lily Neo: May I ask the Minister how many cases of intellectually disabled people are under Public Assistance, presently? Am I not correct to say that there are about 4,800 Public Assistance recipients, which is about 0.1% of total resident population in Singapore? May I ask the Minister whether MSF can be more compassionate and relax that eligibility criteria for Public Assistance to cover those intellectually disabled people, especially those with no family support?

Mr Desmond Lee: Deputy Speaker, I do not have the figures that the Member has asked for. If she files a written Parliamentary Question (PQ), I would be happy to see whether the information can be provided. As for whether we can expand Public Assistance scheme to help people who are unable to support themselves, we will continue to review our schemes.