Speech by Mr , Minister, Prime Minister’s Office at the MCYS Committee of Supply Sitting 2008, 5 March 2008, 4.15pm

[Theme: Living a Long and Happy Life]

Six years ago, a book titled “Authentic Happiness” was published in the US. This is not a typical self-help book. It was written by Dr Martin Seligman, who served as President of the American Psychological Association in the 1990s. He was known then for his work on depression. But when his young daughter accused him of being a grouch, he decided to focus on “what made life worth living”. Today, his book has been translated into 20 languages.

2. Seligman defines “Happiness” in three ways: First, enjoy a pleasurable life – shopping, eating, traveling and other pursuits. Second, enjoy a good life – being totally absorbed in work or hobby, enjoying time with family and friends. Third, enjoy a meaningful life – to pursue a cause that goes beyond the self, such as community work, raising a family, teaching, and even politics.

3. The pursuit of happiness is fundamental to our existence. With an ageing society, our Government’s objective is to help seniors live a happy, healthy and active life.

Financial Security

4. To do this, we need to be free from financial worry - there must be food on the table, and maybe, a little more to enjoy the finer things in life. This is why the Government has devoted a lot of attention to financial security for seniors.

5. Last year, the Workfare Income Supplement scheme was introduced to help lower income workers save for old age. We will help more Singaporeans, especially self-employed and informal workers, to contribute to and benefit from the scheme. We had a debate on this yesterday and today.

6. More recently, the CPF LIFE scheme was introduced, providing CPF members with a steady, basic level of income for the rest of their life.

7. Most important of all, we have encouraged people to work as long as they can, and for as long as they want. With income, there will be more money to spend. We target to raise the employment rate of those in the 55-64 age group to 65% by 2012, from around 56% today.

8. Public discussions have led people to realize, and accept, that they have to work longer. Recently, a relative told me she hopes to retire at 50, but wistfully says she cannot afford to do so. She is a typical Singaporean. AXA, an insurer,

1 has been conducting international retirement surveys for several years. AXA’s most recent finding is that Singaporeans hope to retire earlier than in other developed countries. However, AXA also found that 3 out of 4 working Singaporeans would like to hold a paid job after retirement. What it suggests is that Singaporeans want control over what they do, such as doing a different job with flexible hours or fixed shorter hours.

9. Several MPs have commented on the need to enhance the dignity of seniors through work. I agree. Apart from money, seniors find friends, meaning and purpose at their workplace – these are essential ingredients of happiness.

10. Finding employment for those who are willing and able to work, especially the lower-educated, is vital. Mr has spoken about the CDAC’s Silver Talent Programme. I hope to see similar initiatives being launched this year. This morning, I read that 3 job-related co-operatives are being set up – 2 by our CDCs.

Preventive Health

11. As important as having enough money is having good health.

12. In recent years, the concept of a “rectangular” life has emerged. The Okinawans referred to the balloon analogy, but I will stick to the “rectangular life” analogy. In the ideal world, we live a long and healthy life, followed by a swift and peaceful end. One of my colleagues joked that a way to achieve a “rectangular” life is to live unhealthily – eat char kway teow everyday, smoke, drink, don’t exercise – so that he can die quickly.

13. This seems an appealing thought. But it does not always work out this way. Thanks to good healthcare, many of us can survive a stroke, heart attack or cancer. Instead of having a “rectangular” life, we may face a “triangular” life.

14. The good news is that everywhere in the developed world, the number of years that a senior spends in illness and disability is falling – this is called a “compression of morbidity”. Good sanitation, modern medicine, healthy lifestyles, are the identified key reasons.

15. We will do more to promote a healthy lifestyle in .

16. Science tells us that regular exercise is vital not only for physical health and to reduce the risks of chronic illnesses, but even mental health. Many popular exercises involve social bonding. Yet, three in four Singaporeans, including, or maybe especially seniors, are not exercising regularly.

17. The Straits Times recently reported about Mr Kor Hong Fatt, who completed his ninth marathon at the age of 76. Remarkably, he only started running at 70,

2 after a heart attack. If we have not started early to exercise, it is better late than never - it will improve the quality of life.

18. This year, Mr will chair a committee to promote physical activity for seniors. This is a public-people-private sector initiative to make recommendations, promote and set targets on physical activity for our seniors. The committee will also look at ways to enhance the physical environment, so that seniors are motivated to exercise.

19. The Ministry of Health’s plans to introduce nationwide health screening and nurse educators will also empower seniors to look after their health. Listening to members just now asking for adequate care services for seniors, there are indeed elements, including those from MOH, being put in place.

20. This way, we can look forward not only to a happy life, but also a healthy and long one.

Affordable Healthcare

21. We also need to ensure that healthcare and long-term care is accessible and affordable when it is needed.

22. Improvements to healthcare financing have been progressively introduced. Medishield has been modified to return it to its original purpose, covering the insured for higher hospital bills. Means testing will be introduced so that more help can be given to the lower income.

23. As a proportion of the elderly population will need varying degrees of long- term care, I led a team last year to study the comprehensive Japanese long term care insurance system. We came back strongly convinced that we cannot go down the same path. Mr mentioned that the demand was not according to plan, and the claims simply ballooned. Five to six years after they introduced it, there is a sense of crisis in Japan.

24. Families have been, and should continue to be the first line of support for the elderly. This is what most seniors want. This is what we will probably want for ourselves when we grow old. Family ties are still strong in Singapore. Although adult children are less likely to stay with their parents compared to ten years ago, it is encouraging that the frequency and level of interaction are still strong1.

25. Instead of a comprehensive insurance system that pays for care for the elderly by for profit private sector operators in nursing homes, we should study how we can improve our Eldershield plan to support the family to take care of the old.

1 HDB Houshold Survey (2003)

3 Ministry of Health has indeed enhanced Eldershield payouts, in the event of severe disability. It is 60% higher now, with a slight increase in premiums. The principles underlying Eldershield are sound: pooling of risks, self-reliance, and choice by the individual and family on the type of care, preferably at home.

26. Dr and Mr asked for the Government to provide a caregiver allowance. As our population ages and family size becomes smaller, the burden of caregiving will indeed increase. Caregivers contribute to society by caring for our elderly. But putting a price tag on what is traditionally a family duty should be considered very carefully. It monetizes obligations and responsibilities within the family. Both members have spoken eloquently for a caregiver allowance. What is the solution? Or, should it be: “What are the solutions?” We are studying the matter, including whether there could be further improvements to Eldershield. So sorry, for this year, despite your pleas, we are not announcing a caregiver allowance, but will study solutions to support caregivers.

27. We are also developing a caregiving support framework that includes community-based care and home care. This means that family as first line of care and support is not a mere slogan – we will help it remain a reality.

Ageing in Place

28. I will speak next about our efforts to promote ageing-in-place.

29. The elderly prefer to live in their own homes, within the community. They want to be independent, not institutionalized. They want to be live among friends and family.

30. We have upgraded the environment to enable them to do so. All our public housing estates are on target to achieve Barrier-Free Accessibility by 2011. All new HDB housing will have Universal Design features, friendly to all ages. 40 per cent of the bus fleet will be wheelchair-accessible by 2010.

31. Starting this year, all developments will also have to comply with the enhanced Code on Accessibility in the Built Environment. It will cover facilities such as parks, open spaces, transport stations and bus shelters. Connectivity between buildings and with these facilities will be improved.

32. Over the last few years, the HDB has also built studio apartments for seniors who want to monetize their property but still stay within the community. The HDB has made it even easier for lower-income seniors to age-in-place, by introducing the lease buy-back scheme.

4 33. We will also encourage families to stay near each other. HDB already provides a higher-tier CPF Housing Grant to a first-timer family buying a resale flat, if the family opts to live in the same flat or close to their parents. The HDB will introduce a similar incentive to singles who buy a resale flat and live with their parents. Eligible singles will now get an additional $9,000, or a total of $20,000, if they choose to buy a resale flat to live together with their parents.

34. We will also improve the software to support ageing-in-place. Together with the Ministry of Health, MCYS is looking to enhance the quality and integration of care in the community and home. Therapists will be engaged to introduce “maintenance exercises” at day care centres. To make it easier for low-income seniors to visit these centres, a means-tested transport subsidy will be introduced this year.

35. MCYS has also recently launched a Silver Community Test-bed Programme to encourage companies to develop products that help seniors age- in-place. Themes being pursued include home monitoring and enhancing home safety.

36. The physical and even service aspects of ageing-in-place are relatively easy to achieve. The social aspects, including community self-help, are harder to achieve. I will take these matters under Active Ageing.

Active Ageing, or Wellness

37. Apart from good health, sufficient money and a familiar roof over their heads, happiness also requires our seniors to connect, care and contribute to others. The most natural setting is within the community. Mdm Cynthia Phua and Mr referred to it. What matters is not how many people you know, but the quality of relationships that are formed. This requires people to meet together regularly, more so in small groups than at large events. Physical facilities may not be the solution. The software of getting people to come together is far more important. Mr Wee Siew Kim may wish to know that there is a seniors lounge in Ang Mo Kio, in his constituency. The problem is not the centre itself but the programmes and attracting people to visit. Likewise, for Ms Cynthia Phua, while there is a pause to reevaluate the effectiveness of NL, there is also in her constituency, a St Luke’s center nearby, so it is not for the lack of facilities.

38. For the single elderly without family support, social bonds become even more important. Neighbours and friends can look out for each other, and help one achieve a good life. We are familiar with the Chinese saying “远亲不如近邻”.

39. Mr Sam Tan’s call is for the celebration of life. To achieve it, we need a vibrant and connected neighbourhood.

5 40. The one million dollar question, then, is how do we promote social bonds in the community? Mr Heng Chee How asks: In our changing social environment, how does our grassroots morph to meet the current and future needs of the people? Mr Wee Siew Kim asks for activity centres for the elderly in convenient locations. Notwithstanding my remarks that physical centres may not be the answer, PA is studying both the physical infrastructure, such as community clubs of the future, and the organizational support for grassroots organizations. This will take some time before we come up with concrete plans.

41. Our grassroots organizations, especially the RCs, can and should play a key role in promoting social bonds. PA has embarked on a recruitment campaign for volunteers, targeting the better educated. This year, the People’s Association has decided to focus on “Neighbourliness”. Over the next year, the PA will work with RCs to establish a register of interest groups within their vicinity, not just those formed by the RCs, but also other casual groups. This register will enable the RCs to support these groups and organize platforms for different groups to get together. Collectively, they widen the resident’s social networks.

42. I would like to share three examples of social bonding in action.

43. In Choa Chu Kang, Mr Ravindran Kathergamathamby, a PA staff, started out by organizing parties involving families living on his floor. This year, he decided to organize a bigger get-together for Chinese New Year cum children’s birthday. Some 120 neighbours from eight floors and even their relatives attended the event. They are now organizing outings and overseas trips. By tutoring each other’s children, they save on tuition fees.

44. In Sembawang, Dr challenged his grassroots organizations to host a 100 floor parties in order to reach out to his residents. As an incentive, the residents get to take a group photograph with Dr Lim. To date, a total of 55 floors from 30 different blocks have been covered by the five RCs in Canberra. These floor parties help neighbours foster a “kampung spirit”. I understand Dr Lim is hoping that this initiative will encourage people to organize floor parties on their own, and not depend on the RCs.

45. Seletar Hills is a private landed housing estate. In late 2006, Mrs Chew Swee Liang, a grassroots leader, convinced 38 households to turn their pavements into a mini-garden. She had support from the authorities. From one street, three more streets have been added. 150 households are now involved. From swapping gardening tips, they have gone on to having breakfast and potluck parties. Again, another community that is reviving the old “kampong” spirit.

46. HDB residents know on average 10 neighbors2. However, most of these are “Hello-Good Bye” relationships. Interest groups and parties provide the

2 HDB Household Survey, 2003

6 platforms for neighbors to know each other. When bonds strengthen, they will provide each other with mutual support, so essential for the care of the elderly.

47. Like Mr Sam Tan, we are all saddened to hear about the Wong family in Lorong Ah Soo, where the mother has dementia. Perhaps a closer knit community of neighbors can help reduce such incidents in future. We3 will train the grassroots volunteers to enable them to identify those who need help. There is a programme called the Community Psycho-Geriatric Programme, which was launched last year. Hopefully, VWOs and grassroots will be trained to help out in the community. Social services, including the Elder Protection Team under Transcentre, a VWO, also play an important role in providing assistance.

48. Another VWO, the Alzheimer’s Disease Association, will pilot an initiative to identify seniors with dementia, if they lose their way or are found wandering. Called “Safe-Return”, these seniors will be issued an identification card, which contains the contact information of their next-of-kin.

49. To answer Mr Ong Ah Heng, the Seniors Helpline (1800-555-5555), managed by SAGE Counselling Centre, provides counselling and information and referral services for older persons and their caregivers. Very often people say we don’t know where to call for help . Mdm Foo Yee Shoon offered one. Now this is another one.

50. Dr and Mr Wee Siew Kim spoke on legislation to protect the elderly. We believe that existing legislation is sufficient for now. The Women's Charter and Penal Code protect the elderly against physical and emotional abuse. The Act on the Maintenance of Parents protects against financial neglect. The Mental Capacity Act, when passed in Parliament, makes ill treatment and willful neglect of people with mental incapacity a criminal offence.

51. Real protection comes from preventing these cases from taking place, and, if they do happen, to resolve them through mediation and counseling. Applying the law should be the last resort. It makes reconciliation almost impossible. Social workers find that many family disputes can be resolved. Frequently, the issues revolve around ignorance about caregiving and relationship issues, financial hardships, and even neglect or unbecoming behaviour by the parents. There is only a small minority of ‘unfilial children’ which should be swiftly dealt with by the law.

52. We will continue to make efforts to raise public awareness of elder abuse and maintenance of parents. But as importantly, we must strengthen the help offered to the elderly, to reconcile with their family, where possible. Very often, the one being complained about is also the one giving the care. So we have to be very careful not to break this relationship. Neighbours can play their part, to help

3 The Ministry of Health’s Community Psycho-Geriatric Programme and the National Council of Social Services’ Social Service Training Institute

7 watch out for elderly neighbours and support those with caregiving responsibilities – this is why strong social bonds in the community are important.

53. Whilst the community can facilitate and support, the individual must also do their part to be active. Our seniors lead very sedentary lives. Hitherto, society’s image of the elderly is that of frail men and women using walking aids or wheelchairs. This is not true of our seniors above 75 – 8 in 10 of them do not need walking aids to get around4. The emerging generation of seniors – post-war baby boomers – are even better educated, healthier and probably wealthier.

54. So we have to change the conventional image of the elderly.

55. Mr asked what we are doing to promote an active lifestyle for seniors. Last May, the Council for Third Age was established to champion active ageing. MCYS currently funds the Council. On the ministry’s behalf, the Council also administers public education and the Golden Opportunities (GO!) Fund.

56. One of the first things the Council did was to re-brand Senior Citizens’ Week to the Active Ageing Festival, which was held last November. The Festival had a good start. This year, the Council intends to promote active ageing more extensively. It will work with the five CDCs to bring this message to the community.

57. Over the next 2 years, a Wellness Programme will be piloted in six sites all over the island. Two have been launched at Jurong Central and Punggol South. The key objective of the Wellness Programme is to support seniors in the community by identifying and meeting their needs, through information and referral, service co-ordination and development, as well as outreach efforts to promote active ageing and wellness. Each site is expected to reach out to at least 1,000 seniors. MCYS is allocating $4 million to this pilot. One element of this is to help the seniors improve the quality of their life. Health screening is one element, but it is more difficult to move them to an active and healthy lifestyle.

58. Although each Wellness Programme will have at least two full-time staff, the support of the Advisor, grassroots leaders, government agencies and community- at-large is crucial to ensure it meets these objectives. The objectives of the Wellness Programme are very much in line with the fundamental objectives of GROs – bonding the community. So this Wellness Programme is not what we do separately, but together with the GROs in the community.

59. For now, the Wellness Programme is a pilot. Each site is given the leeway to experiment with what works best for their community. Outcome indicators will be monitored closely to track its effectiveness. After two years, the Government will evaluate how the Wellness Programme can be rolled out nationwide. While

4 National Survey on Senior Citizens, MCYS (2005)

8 members are very anxious to have similar programmes in their constituencies, we should find out what we should do in these programmes to ensure that they deliver results.

Silver Industry

60. So far, I have shared what the Government, in partnership with the people sector, is doing to help seniors achieve a happy, healthy and active life. But there is no reason why the private sector cannot be involved. The private sector can service the needs of our ageing population, while being profitable at the same time. The Health Ministry’s pilot scheme to open up subsidized nursing home beds to the private sector is an interesting experiment.

61. Two months ago, the Silver Industry Committee under Mr Philip Yeo successfully organized a silver industry conference and exhibition. The public response has been very encouraging. I understand that exhibitors are keen to participate next year.

62. Scaling up for the silver business is increasingly possible. It is not just Singapore which is rapidly ageing, but also the rest of Asia. By 2050, 1.2 billion people5 will be above 60 years old, four times the number today. This is as large as China’s population today!

63. This year, the EDB has made health and wellness a key growth theme. It intends to work with partners, such as healthcare providers, to create development platforms such as “Hospital of the Future” and Home and Community Care. These platforms allow companies to develop products and services for an ageing population.

Conclusion

64. Last year, I shared that the Ministerial Committee of Ageing would pursue four strategic thrusts: Financial Security, Healthcare, Ageing-in-Place and Active Ageing. We are making progress in all these areas. These thrusts all lead to one vision of successful ageing – happy, healthy and active seniors. The Government cannot do this alone. The family and community provide the social bonds and care that make life worth living. The individual must be committed to a long and happy life.

65. At 110 years old, Sister Teresa Hsu is probably the oldest active ager in Singapore. She has been serving the community most of her life. I would like to share a quote on her philosophy of life: “I prefer to laugh than to weep. Those

5 UN Population statistics

9 people who cry to me, I always tell them it is better to laugh than to use tissue paper. Laughing is free but tissue paper still cost five cents.”

66. Teresa Hsu is committed to a long and happy life. May all Singaporeans emulate her.

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