Extend state subsidies to private eldercare facilities

Extend state subsidies to private eldercare facilities

Coffee-shop assistant Wong Meng Lin, 55, shells out about a third of her $1,000 monthly take-home pay to send her 83-year-old mother to an eldercare centre while she is at work.

The older woman has dementia and cannot be left alone at home. The centre sends a van for her, but the daily commute can take 45 minutes each way, since other clients are picked up too.

So when Ms Wong chanced upon a new day-care centre for the elderly near her home, she immediately dropped in to inquire if it could accommodate her mum.

The Kallang Bahru centre has ample vacancies. But it is run by a private company, Goldencare Group, and its clients do not receive the government subsidies that apply at similar centres run by voluntary welfare organisations (VWOs).

While VWO-run centres receive subsidies for needy clients, they are also subject to regular checks by the Ministry of Health (MOH).

They must also meet some ministry requirements on safe and appropriate care, staffing qualifications and so forth.

Goldencare gets no subsidies, does not need to meet these requirements and is also not audited for its quality of care.

This needs to change.

The centre is the brainchild of Ms Sim Kah Cheng, 47, a nurse with nearly two decades of experience at restructured hospitals and polyclinics.

Aware that Singapore has one of the fastest rates of ageing in the world - and eldercare infrastructure may well fall short - she decided to set up the centre with help from private investors.

She points out that Singaporean children who attend private childcare centres are eligible for state subsidies. "In many ways, the need for subsidies may be greater in eldercare, since we are essentially a fast-ageing nation with very low fertility rates," she says.

She thinks centres such as hers can keep frail, elderly people active and engaged while their caregivers are at work.

An MOH spokesman told The Sunday Times the ministry welcomes the involvement of private-sector players in the provision of eldercare services.

Upcoming eldercare centres that are co-located with nursing homes will receive subsidies, irrespective of whether they are run by private groups or VWOs.

The ministry is looking into how to extend these "portable" means-tested subsidies.

However, such a scheme must include a framework to manage price increases and a quality-assurance system to better ensure quality care at affordable prices, the spokesman said. Such safeguards are indeed important.

After public consultations, the ministry is finalising a set of guidelines to define good care in day-care and day-rehabilitation centres for seniors. The spokesman said these guidelines will provide a basis to study the extension of eldercare subsidies more widely among existing centres.

With Singapore ageing faster than most other nations, I hope such decisions can be made soon.

As of last June, there were already more than 430,000 people here aged 65 and above, up by nearly 100,000 from just four years earlier.

While people are living longer, not everyone is living well.

Estimates from the latest National Health Survey made public in late 2011 showed that Singapore had around 210,000 people who were looking after elderly, sick or disabled folk at home.

I have spoken to many caregivers who have had to quit their jobs to look after loved ones at home.

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