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For it to be effective ... ; Step-down healthcare must have support of families, hospitals, GPs, VWOs TODAY 17 August 2009 THERE is a “new social phenomenon” that is causing Prime Minister Lee Hsien Loong “great discomfort”. And that is Singaporeans abandoning their parents in nursing homes or hospitals. Recounting what he had been told by some nursing home operators, Mr Lee said in his Mandarin speech: “After they send the parents to the homes, sometimes they disappeared and even changed the addresses on their ICs. “When the nursing home contacted them, they said ‘it’s not my business’, and said that even if the nursing homes were to drive the parents away, they would not care.” The Government is studying how best to use the Maintenance of Parents Act to deal with such cases, added Mr Lee. Even as Singapore’s healthcare system is in the process of being restructured to cater to an ageing population, the Prime Minister drove home the message that families must not shirk their responsibility of caring for ill, elderly members. While the Government is taking steps with the hardware of step-down care — in the form of community hospitals, nursing homes and enhanced home-care — doctors, welfare organisations and patients must cooperate as well. To patients, for instance, Mr Lee advised: “Please don’t insist on being in the acute hospital, getting high-tech, fast medicine, if the doctor advises you that you’ll be okay, go to the community hospital ... you’ll get better and more appropriate treatment.” He also hoped that voluntary welfare organisations, which today provide the bulk of step-down care here, would work with the Government as their role was “crucial”. The changes to the healthcare system are because older patients require a different pattern of healthcare. One key move is to link acute and community hospitals, so there can be “the best of both worlds”, said Mr Lee. That is, stabilised patients can be transferred to a community hospital to receive “slow medicine” and, if necessary, transferred back to an acute hospital for treatment. The tie-up between the new management at Ren Ci Hospital and Tan Tock Seng Hospital (TTSH) illustrates how one can complement the other: TTSH guides the medical care of Ren Ci’s patients, while Ren Ci’s volunteers help keep patients active and happy. But patients cannot stay in a community hospital indefinitely, Mr Lee pointed out. This is where home care comes in. Acknowledging that families may need help in this area, Mr Lee said, the Ministry of Health is working on upgrading home care. He also called on individuals to exercise responsibility and keep healthcare costs down by maintaining healthy lifestyles. Such change in attitudes and lifestyles “requires discipline and perseverance”, he noted: “Lectures and speeches won’t work.” He suggested community programmes like qigong or brisk-walking, which combine fitness with fun and social elements. The Wellness Programme, which was piloted in 12 constituencies, will be progressively expanded to cover the whole island, he added. |
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