Mr Dennis Tan Lip Fong (Hougang): Mr Deputy Speaker, for my Budget Debate speech today, I would, first, like to speak on certain issues relating to the support for our seniors followed by the issue of support for adults with disabilities and, finally, like in my previous year’s Budget Debate speech, I will continue with the issue of green transition.
Mr Deputy Speaker, Deputy Prime Minister and Finance Minister Lawrence Wong said in his Budget speech that preventive care is especially important for seniors, that loneliness can do great harm to a senior. They need to stay active and socially connected. Hence, the Government will set aside $3.5 billion to start the Age Well SG for the next decade. There are several components to this, and one component is that there will be an expanded network of Active Ageing Centres (AACs) providing a wider range of programmes.
Mr Deputy Speaker, as always, the devil is in the details and I look forward to hearing more details from the Ministers in charge on the changes and plans for AACs but, in the meantime, I have several comments and questions.
First, I would like to ask the Ministry of Health (MOH) what is the current situation with the staffing as well as the recruitment efforts for our AACs? How will MOH assist our AACs to recruit and maintain additional staff to tackle the manpower needs for a bigger scale AAC landscape? Does the Government have a guideline in mind for the manpower staffing per centre under AAC 2.0, of course, taking into consideration that requirements for clusters may vary according to the size of the cluster? AACs have a mix of staff and volunteers while staff strength of AACs may vary from centre to centre and volunteers are also an integral part of AACs. Volunteers may not always be able to take over the roles, expertise and, indeed, professionalism of the professionals in our AACs.
Next, for the group of seniors who do not wish to be involved in their AAC activities or do not desire to keep in contact with their AACs, I would like to know what are the plans that Age Well SG may have for them as far as outreach and keeping in contact are concerned? This will be in line with tackling loneliness and addressing the need for seniors to be socially connected, as mentioned by Deputy Prime Minister Wong.
I am especially concerned with those who live alone, keep to themselves and who are not close to their families or neighbours. Beyond having more or more varied activities, we need to study what approach can be taken to better enable AACs to keep in regular contact with this group, at least to provide support when it is needed.
Studies should also be done to see how AACs can attract better male participation.
Deputy Prime Minister Wong also mentioned in his speech of silver upgrades to our residential estates to enable seniors to live more independently and safely in the community by way of amenities, such as therapeutic gardens and barrier-free ramps and senior-friendly home fittings, such as wider toilet entrances and shower seats. I look forward to more details from the Government, including how these amenities will be made available to residents in their homes and in our common spaces.
Deputy Prime Minister Wong also mentioned that there will be improvements to infrastructure for seniors’ mobility and safety, such as more sheltered linkways, bus stops with senior-friendly features as well as safer and more pedestrian-friendly roads. I welcome these. As recently as August 2022, in an answer to a Parliamentary Question, the then-Minister for Transport said that there were no plans to expand the criteria of Land Transport Authority’s (LTA’s) existing covered linkway programme covering a 400-metre radius of major transport nodes, such as MRT, LRT stations and bus interchanges. I hope that there is now a rethink about this approach for covered linkways, especially on lands administered by LTA or other state lands. LTA should consider linking at least the heavily utilised bus stops to nearby housing estates. For example, working with Town Councils to link up such heavily utilised bus stops with the nearest covered walkways within the HDB estates.
Still relating to seniors, the Budget will give all Singaporeans born in 1973 or earlier a MediSave Bonus of $750 and double this at $1,500 if they are part of the Majulah Generation and their residence has an annual value of not more than $25,000.
For seniors with especially multiple chronic illnesses and frequent medical appointments, this MediSave top-up will not help much as long as the annual MediSave withdrawal limit remains at $700 a year for patients with chronic illnesses. Can the Government look at increasing the cap for the MediSave withdrawal limit for seniors with multiple chronic conditions so that such seniors, especially seniors who are retired and not working or are unable to work, will be less out of pocket when paying their bills? I know that the MediSave withdrawal limit was revised in January 2021. Would it now be timely for the limit to be raised, at the very least, to keep up with elevated inflation?
Given that the quarterly quantum of Silver Support Scheme will now be raised by 20%, can the Government consider raising MediSave withdrawal limits from, say, $500 to $600 and from $700 to $840 for chronic cases as well and that those suffering from multiple illnesses be granted further extension of the caps on a case-by-case basis? Mr Speaker, in Mandarin, please.
(In Mandarin): [Please refer to Vernacular Speech.] Deputy Prime Minister and Minister for Finance Lawrence Wong emphasised in the Budget that the Government would strengthen its support for the elderly. I hope the relevant Ministers can share more details on this.
Deputy Prime Minister Wong mentioned that the refurbishment and enhancement of senior-friendly facilities in neighbourhood to enable the elderly to live more independently and safely in the community. This includes expanding sheltered walkways and bus stops with elderly-friendly features. In August 2022, the then Transport Minister stated that the Land Transport Authority (LTA) did not have plans to expand existing sheltered walkways. Currently, LTA’s sheltered walkway coverage is limited to within 400 metres of MRT stations and bus interchanges. I hope the Government can reconsider this strategy, especially in LTA managed or state-owned areas. For example, LTA could consider collaborating with the Town Councils to connect HDB neighbourhoods with sheltered walkways to busy bus stops.
Furthermore, the Budget also includes a one-time MediSave Bonus for eligible Singaporeans. The amount is determined based on age and the annual value of the individual’s residence, ranging from $700 to $1,500.
For elderly individuals with multiple chronic illness would need frequent outpatient care, especially those who are retired or unable to work, if the annual withdrawal limit remains at $700, this top-up may not provide much help to them. The withdrawal limit was last revised in 2021. In times of rising prices, will the Government consider raising the withdrawal limit for MediSave to reduce the cash outlay for retirees?
The Silver Support Scheme is set to be increased by 20%. Will the Government also consider increasing the withdrawal limit for MediSave by the same 20%?
(In English): I will next touch on the issue of support for adults with disabilities.
I welcome Deputy Prime Minister Wong’s announcement that he will provide more support for adults with disabilities. He said he will expand spaces in sheltered workshops and day activity centres where they can undergo skills training and launch more enabling services hubs to provide community support to persons with disabilities and their caregivers. I believe that, as a society, there is a lot more we can and should do for adults with disabilities among us, in particular, adults with serious special needs as well as their caregivers.
Earlier this month, I filed a Parliamentary Question asking whether the Ministry of Social and Family Development (MSF) will consider increasing the number of day activity centres and residential homes for adult persons with autism. Minister Masagos replied that there are currently eight day activity centres serving adults with autism spectrum disorder with over 300 clients enrolled in these day activity centres and about 80 referrals pending enrolment. He also said that there are four adult disability homes funded by MSF serving adults with autism spectrum disorder. There are about 50 residents with autism spectrum disorder in these adult disability homes which have the capacity to house about 100 residents, and about 20 referrals are pending enrolment.
Mr Deputy Speaker, I believe there is such a need to increase our day activity centres and residential homes. I believe that we really should increase our resources to provide continuous training for adults with disabilities, including but not limited to special needs adults, such as those with moderate to severe autism beyond their time in the SPED schools. In my view, there are multiple possible benefits. We should continue to think of ways to improve long-term post-SPED school education or training, providing further education and skills training, if possible.
More studies should be done to increase the possible range of work training these adults can undergo and the range of work they can undertake in society. This will enhance their lives and promote better integration with society. At the same time, spending time at day activity centres rather than at home, with structured programmes, activities and interaction with others will enhance the mental well-being of such adults.
My heart also goes out to senior caregivers and their special needs adult children, wondering what is going to happen to the care of their children when their health gives way one day. Even when these parents may have other children who are non-special needs, is it appropriate to expect them to take over care of their siblings when their parents pass on? Should we not provide adequate residential homes for these adults with more structured care and development? And can we also consider for these homes to allow some of the special needs adults to be able to go home to their families on weekends, providing some balance between residential care and home care, allowing family members suitable respite in the process?
Minister Masagos also said that MSF has been working with the sector to develop plans to better support adults with autism and their families, given the increase in awareness of autism and in the clarity of its diagnostic criteria and that MSF will share more details in the coming months. Indeed, I hope that MSF is able to share such details during COS, including details of any studies undertaken recently.
In November last year, I filed a Parliamentary Question asking the Minister, among other things, whether the Ministry keeps a record of the current number of elderly caregivers who are caring for adult persons with intellectual disabilities and whether the Ministry will consider developing and implementing early identification and support programmes for such caregivers. Senior Minister of State Tan Kiat How mentioned in his reply that MSF does not directly track the number of elderly caregivers who are caring for adults with intellectual disabilities.
In December 2023, news broke that one of my Hougang residents, an adult with special needs, stayed in his flat with the body of his elderly father after his passing for five days while continuing to attend day sessions at the day care centre. While I am extremely thankful that the authorities and stakeholders were commendably quick to assist and arrange for care for the son thereafter, this case reinforces the need for us to consider developing and implementing an early identification and support programme for elderly caregivers who are caring for adults with special needs.
Such a programme could adopt a multi-agency approach that involves our AACs, day care centres for adults with disabilities, healthcare providers and even service providers like lawyers who may have interactions with family members in the course of their related work, for example, doing Lasting Power of Attorney (LPA), as well stakeholder agencies like Agency for Integrated Care (AIC) and MSF, such that each party can trigger another party to provide necessary checks or support for the family concerned. Studies should be done to see how contact and support can be appropriately maintained by one or more stakeholders for both elderly caregivers as well as the special needs adults.
Last year, I said in my Budget debate speech that we should work towards AACs, which cater to the different needs of seniors, whether social or medical, or for more specialised areas like mental health or disabled persons who are seniors. The centres should still be referring centres even if other organisations or sub-units are involved. Indeed, an expanded AAC can also perform the coordinator or contact role for elderly caregivers of adults with disabilities.
Mr Deputy Speaker, let me know move on to ongoing efforts for green transition. Last year, I said in my Budget debate speech that we need a detailed roadmap for retraining workers in these sectors as Singapore decarbonises. I asked whether we have sufficient sustainability-related courses that businesses and workers can afford to attend, both in terms of time and money. In my speech today, I will go on to talk about the quality of the education to be provided.
Mr Deputy Speaker, capacity building is a core concept of development. In the context of climate change and sustainable development, upskilling is now necessary to ensure a just transition and that no worker is left behind.
Singapore has been investing heavily in lifelong learning and upskilling since SkillsFuture was launched back in 2015. Government spending has shifted towards adult education and training to accelerate the nation’s green transitions. IHLs form the backbone of this shift and there exists a multitude of courses available to build capacity and upskill the existing work force in areas such as environmental, social and governance (ESG) and carbon services and trading.
However, growing our talent pipeline must also include investing in primary, secondary and tertiary education. I am pleased to hear of a new Master of Science (MSc) in climate change and sustainability programme at the National University of Singapore (NUS). The MSc programme in data science for sustainability was also launched in NUS to train data scientists who can integrate their knowledge and skills with an understanding of sustainability issues. The Nanyang Technological University (NTU) has the Asian School of the Environment and offers majors in environmental and earth systems science, public policy and even a second major in sustainability. These are examples of positive development in Singapore.
But to ensure that graduates are well equipped to meet the demands of the times, all such courses must go through sufficient policy and industry validation. For instance, IHLs should, if they have not done so, internalise the SkillsFuture reports to assess SkillsFuture needs in these areas and assess what skill sets they have to teach undergraduates and graduate students. We should also encourage our course providers to ensure that all courses provide adequate time, emphasis and coverage on Singapore, so that students can really understand how to green Singapore and the challenges that Singapore face.
Do knowledge providers have the right people to teach and impart such knowledge and skills? How do we ensure this? Some form of impact assessment is necessary to track lifelong learners’ progress, comprehension and application.
Second, knowledge and content providers across the IHLs also need to be given adequate support to do this important work of providing the knowledge and skills for the workforce. Hiring practices at university need to reflect contribution to society beyond traditional publication and impact factors. If Singapore is to succeed in our green transition, more emphasis needs to be placed on hiring experts that have real-world experience in solving complex sustainability challenges.
Demand is also growing for Singapore to help build regional and international capacity. Overall, there is growing demand for Singapore’s experts to be ready and available to impart valuable knowledge. To do so, we need more Singaporeans to step forward with the right knowledge, skills and attitude to help grow our local, regional and international sustainability talent. Indeed, we need to actively grow our pool of educators.
Climate change demands urgent action from everyone, across all sectors of society. As we focus on upskilling and capacity building of workers, we must also not overlook the support and training we need to give our educators. We need to grow our pool of sustainability educators and we need to do so fast in this quick journey of manpower transition, so that we do not lag behind our 2030 and 2050 goals.
Mr Deputy Speaker, in closing, I look forward to the replies to the concerns I have raised.
26 February 2024
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Office of the Leader of the Opposition 