Singapore's palliative care sector to get boost

National plan for palliative care to come, says Health Minister

By Janice Tai, The Straits Times, 8 Nov 2011

MORE will be done to ensure Singaporeans nearing the end of their lives are well cared for, Health Minister Gan Kim Yong said last night.

A national strategy for palliative care is being formulated and it will, among other things, help determine the resources that are needed in this area.

Details will be announced soon, he said at the 42nd anniversary dinner of Assisi Hospice, one of Singapore's oldest and most established hospices.

Mr Gan noted that with people living longer and the rise in chronic diseases, the medical care that people require at the end of their lives will change significantly.

For example, while in the past, people often died of acute illnesses such as infections or heart attacks, people today increasingly die after a period of progressive disability due to an incurable condition, such as advanced cancer, progressive organ failure or advanced dementia.

Although palliative care historically focused on patients with advanced cancer, there is increasing recognition that patients with non-cancer conditions can also benefit from palliative care, he said.

Addressing about 600 people, including Temasek Holdings' chief executive Ho Ching, the patron of Assisi Hospice, he said Singapore has made good progress in developing palliative care services.

While they began as home hospice services and inpatient hospices, such services are now available in acute hospitals and piloted in a few nursing homes.

Currently, there are seven inpatient and home hospice providers which serve about 5,000 palliative care patients yearly.

The number of health-care professionals trained in palliative care is also on the rise, with the number of nurses trained in palliative care increasing by about 14 per cent over the past year to 294 this year, from 257 last year.

He noted that the Lien Centre for Palliative Care had been asked by the Ministry of Health to work out the national strategy for palliative care, with input from the palliative-care community.

Former health minister Khaw Boon Wan revealed last year that a code of ethics may be included in the national strategy.

Mr Gan also encouraged Singaporeans to actively make choices on end-of-life care before they are struck by a debilitating illness.

'While death is inevitable, it need not be filled with agony and helplessness,' he said at the dinner at the Pan Pacific Hotel.

Through advance care planning, patients, families and health-care professionals are encouraged to talk more about end-of-life care and treatment decisions before palliative care is required.

This is already taking place in some hospitals and nursing homes today.

Don't sell your HDB flat, Mr Lee Kuan Yew tells resident

Former PM gives advice during visit to Sers project in Holland Drive
By Andrea Ong, The Straits Times, 7 Nov 2011

BUSINESSMAN Lim Tow Nam, 53, moved into his new, spacious flat on the 38th floor of Block 18C in Holland Drive earlier this year, after living in his old flat a stone's throw away for around 20 years.

He and his family love the breathtaking view from their five-room flat - they can see as far as Sentosa and Keppel Bay.

Holland Village is nearby, while the new Holland Village MRT station and Buona Vista MRT station are both within walking distance.

Mr Lim's parents and two sisters live in three separate flats in the same block. The family have dinner every night at his parents' flat.

Mr Lim bought his new flat for just $380,000 - a subsidised price for residents under the Selective Enbloc Redevelopment Scheme (Sers). His old flat had cost him about $165,000.

The Sers project rehouses residents from six old blocks near Holland Village in four new high-rise blocks in Holland Drive.

Yesterday, Mr Lim had words of advice from none other than former prime minister Lee Kuan Yew, who visited him in his flat in the early evening.

'He told me, don't sell. The price will go up,' Mr Lim told The Straits Times.

'I think he loved the view and felt happy about our asset enhancement,' he added.

Tree Planting Day

Marking 40 years of tree planting

FORTY years after he started the first Tree Planting Day, former prime minister Lee Kuan Yew showed he was still handy with a shovel at yesterday's (Nov 6, 2011) tree-planting ceremony and community party in the Buona Vista ward of his Tanjong Pagar GRC.

The event marked the launch of Buona Vista Court, four blocks in Holland Drive built to rehouse Holland Village residents under the Selective En bloc Redevelopment Scheme. With Mr Lee are his other GRC MPs, Mr Chan Chun Sing, Radin Mas MP Sam Tan and Ms Indranee Rajah.

The truth about my father's health

Struck with a rare ailment, he'll fight it with all the energy he can muster

By Lee Wei Ling, Published The Straits Times, 6 Nov 2011

In my last article in this space, 'Living a life with no regrets', I wrote about my father's deteriorating health due to my mother's illness and subsequent demise. I wrote truthfully and frankly, for that has been my 'style' in both writing and speech for as long as I can remember.

My father had read the draft as well as the published version of the article, and had e-mailed me to say, in his usual understated way, 'reads well'. The following week, when I showed him the positive feedback from two readers on the article, he paused for a moment, then said: 'Let the readers know I have sensory peripheral neuropathy.'

In my father's case, sensory peripheral neuropathy has caused the conduction of sensation from his legs to his spinal cord to be impaired. This makes his walking unsteady, as many Singaporeans have already noticed.

I was there when the American television journalist Charlie Rose engaged my father in a dialogue in Istanbul, Turkey, recently. I was also there when he delivered a speech at Ford's Theatre in Washington DC before receiving the Lincoln Medal.

There was also a dinner hosted by Mr Fred Malek, a prominent member of the Republican Party, as well as dinner and lunch in Kent, a small town in Connecticut where Dr Henry Kissinger has his weekend home. The guests at these functions were all influential, with some of them having driven hours to see my father.

My father was in top form at all the events. He was asked for his opinion on many issues, and he did not get as many opportunities to ask questions of his interlocutors.

Public hospitals 'borrow' space

EASING THE BED CRUNCH

The solution to the perennial lack of hospital beds could be to tap into private resources, reports Melissa Pang
The Straits Times, 6 Nov 2011

On one side are public hospitals facing a bed and doctor crunch. On the other are private hospitals with spare capacity.

Would it not make sense for patients from the former to be seen in the latter?

That could well happen, marking yet another milestone in Singapore's health-care system.

One sentence in the Health Ministry's recent addenda to the President's Address read: 'Private acute hospitals will have a greater role in serving the subsidised health-care needs of Singaporeans.'

It was not the first time the Government had raised the idea of public-private sector collaboration.

At Raffles Medical Group's 35th anniversary dinner in July, Deputy Prime Minister Tharman Shanmugaratnam said the Government was studying a plan to let private health-care providers train doctors and treat subsidised patients.

He noted that a growing number of doctors have moved into private practice, and for the vast majority who do so, 'it is like crossing the Rubicon - there is no turning back'.

'We have to find systemic solutions to avoid this being a zero-sum game,' he said.

Doctors, health economists and other observers noted that there is already collaboration at the general practitioner level, under the Primary Care Partnership Scheme.

If this was widened so that private hospitals take on subsidised patients, it would be a matter of necessity rather than choice.

Chiefly, public hospitals are facing a serious shortage of beds and doctors. Many hospitals are running at more than 90 per cent capacity, whereas most private hospitals have surplus space.

Riding Asia's growth over the next decade

A new report from DBS Bank, titled Imagining Asia 2020, details how Asia will grow over the next decade.
In an interview with Yasmine Yahya, DBS strategists explain how investors can ride this growth.
The Straits Times, 6 Nov 2011

The ongoing debt crisis in the euro zone and the unemployment and debt problems in the United States have shown the world that Asia is really where the money is.

After all, Asia has grown at a remarkable speed over the past decade, and is expected to continue to do so in the next 10 years.

DBS said in its report that the Asia 10 - China, Hong Kong, Taiwan, South Korea, Singapore, Malaysia, Indonesia, Thailand, the Philippines and India - will have a combined gross domestic product of US$22.4 trillion (S$28.4 trillion) in 2020, some 17 per cent larger than the US economy's.

DBS' head of investment communications, Ms Mah Ching Cheng, told The Sunday Times that with selective long-term investments in certain stocks and bonds, investors could tap this growth for their own wealth creation.

Birds ruffle residents' feathers

Agencies looking into ways to curb noisy flock that leaves messy droppings in Hougang

By Judith Tan, The Straits Times, 6 Nov 2011

Hougang resident Daniel Heng gets a rude awakening at dawn every day.

A large flock of birds, believed to be mynahs, uses the trees near his flat at Block 362, as a transit point, creating a ruckus.

'They come back every evening around 6.45pm to 7.30pm. I feel sorry for my kids, whose bedrooms directly face the tree,' he said.

Residents at two other blocks along the Hougang stretch of Upper Serangoon Road - Blocks 701 and 302 - are also affected.

Housewife Linda Lim, who lives in Block 701, said that cars parked there also 'get decorated with bird droppings'.

'It is not only unsightly but it also damages the cars' paintwork,' she added.

A Sunday Times team, on a recent weekend visit there, found parts of the walkways dotted with bird droppings. Incessant squawking from the birds was also heard for almost 45 minutes.

Mr Heng said trucks passing by at night would set off a new round of squawking, waking residents up.

During several sharing sessions, residents complained to their Member of Parliament, Mr Yaw Shin Leong.

More patients medically evacuated to Singapore

Companies, hospitals here see up to 30% growth in demand for such services

By Melissa Pang, The Straits Times, 6 Nov 2011

At 4pm last Wednesday, Singapore-based air ambulance service Express Medical Assistance received an urgent call from Indonesia.

A 90-year-old woman from Medan had pneu-monia and her family wanted Singapore doctors to treat her, the caller said.

By 10pm the same day, she had been flown out of Medan and warded in a private Singapore hospital.

Before that, there was a flurry of phone calls to assess her health condition, secure a hospital bed and sort out paperwork for the flight.

It was all in a day's work for Express Medical Assistance. More foreigners, like this woman from Medan, are being medically evacuated here.

There are at least five medical evacuation services here. A number have their own air ambulances.

These companies, and hospitals here, have observed year-on-year growth of between 5 and 30 per cent in demand for such services.

Sir Alex Ferguson's 25 years at Manchester United

Sir Alex's fairytale

Sir Alex admits his 25 glorious years in charge of United have been something of a "fairytale".

The boss celebrates the remarkable landmark on Sunday after being appointed in 1986 and is vowing to continue in the job for as long as his health allows him.

"It's been a really fantastic spell for me and something you don't think is going to happen," he stated. "It's been a bit of a fairytale to last so long and I appreciate that.

"I've been very fortunate to have some of the best players in the game and, when I look back on these players I think about how fortunate I am. It's incredible when you look at who's been here - Bryan Robson, Norman Whiteside, Brian McClair, Mark Hughes, Paul Ince, Roy Keane, Eric Cantona. What a collection of fantastic players.

"It's hard to think I actually controlled all these players for so long. Today, we have so many players with different personalities from different cultures."

Even though the manager has overseen many changes to the game, he is still very much up for the challenge of keeping United competitive on all fronts.

"I'll continue as long as I feel healthy enough to do it," he insisted. "In management, things change as the years go on. It's different now even to seven or eight years ago. A lot of things have changed."

Tripartism and Industrial peace in Singapore

Trust and the commitment to fairness

Tripartism has given us years of industrial peace and prosperity, but trust must work both ways
By Eugene K B Tan, TODAY 4 Nov 2011

The current economic uncertainty has generated a lot of angst, anger and anxiety in labour relations across the globe.

Greece, for example, is in the throes of a social upheaval over the austerity measures demanded by the euro zone partners as part of its debt rescue package.

Closer to home, the extraordinary decision last Saturday of the Qantas management to ground its domestic and international fleets most vividly demonstrated that it is in economically challenging times that labour relations are stress tested. That fateful management decision, the full implications of which are still unknown, has done tremendous damage not just to the Qantas brand name but to Australia as well.

The Gillard government had to apply to the industrial court to stop the industrial action. Trust between Qantas, the unions and the Australian government, already in short supply, is now almost non-existent. The three Qantas unions do not trust the airline's repeated claims about its financial viability. Ironically, the unions' attempt to secure job security (an issue tied in with outsourcing and sending jobs overseas) has made the central issue even more challenging - in that Qantas employees' job security is now even more uncertain given the severe reputational damage to Qantas.

Industrial peace in Singapore has been attributed to our unique model of tripartism. This involves the trade unions (led by the NTUC), employers and the Government. Predicated on the fundamental need to create good jobs for Singaporeans, tripartism has ostensibly helped to create trust among the three key stakeholders at the workplace. It also espouses a deep commitment to fairness, taking a long-term view of issues and a practical approach to problem solving.

This approach has enabled Singapore to cut costs and respond swiftly to changing economic conditions, including the Central Provident Fund (CPF) cuts during the 1986 recession and 1999 Asian financial crisis, as well as retuning the CPF in 2003 to maintain cost competitiveness. The state of harmonious tripartite relations engendered is a competitive advantage that Singapore enjoys.

As the income gap has grown in Singapore as well as concerns over whether Singaporeans remain at the core of the workforce, questions have naturally arisen over whether our tripartite model of industrial relations is weighted in favour of employers and the Government.

There is the perception, accurate or otherwise, that workers bear a disproportionate burden during economic downturns, while corporate entities reap a disproportionate share of the benefits when things turn around.

Critics have pointed to how quickly wages are cut and that wage restorations take so much longer. A common gripe is how employers' CPF contribution rates have not been fully restored to 20 per cent. The abiding concern with competitiveness has meant that a premium is placed on harmony at the workplace. For the government, harmonious industrial relations have facilitated the creation of a conducive environment for job creation.

Coupled with a more competitive political landscape, it is not surprising if NTUC's 50-year symbiotic relationship with the ruling People's Action Party will come under greater scrutiny. Can tripartism retain its relevance if the perception is that the economic pie is shrinking or that one tripartite stakeholder is doing the heavy lifting?

HDB block in Pasir Ris rejects lift upgrading

Before we get to the story, I would like to share this part of PM Lee's speech at the debate on the Presidents's address in Parliament on 20 Oct 2011;

"Singaporeans themselves play a critical role in making our democracy work. They have to be active citizens, working for causes which they believe in, but united by a larger common cause, which is to make Singapore grow and prosper. Interests will not always be aligned. It is not in the nature of human beings or human societies that we are all clones of one another and all have exactly the same ideas and interests. Therefore we need to work harder to build consensus, to compromise, to give and take for the common good. And I think as incomes go up, as people become more educated, this will take more work. 

Take for example the recent story, which many of you would have read, about the nursing home which needs to be built in Bukit Batok. The residents are concerned; they would prefer not to have a nursing home next to where they live. The concerns have some basis and their emotions are understandable. And yet if every neighbourhood in Singapore rejects having a nursing home nearby, then there will be no nursing home built in Singapore and I think we will all be worse off.

It is not just Singaporeans who have such a psychology. It happens in many countries. There is even a word for it, it is called NIMBY – Not In My Backyard. You have bought a house, the house is worth something, somebody puts a facility next to your house, property value may be affected, please put it elsewhere. Next block is all right – then it’s not too far for me to walk, but downstairs affects my amenities. And this will crop up repeatedly, especially in a crowded city like Singapore. 

To make every deal win-win-win, I think it is very hard. But on each deal, you win some, you lose some, overall, painting it over the big picture, we all win, I think that is possible. And if we have good faith, if we trust one another and we work together with one another, I think we can make that possible.

We cannot afford to let every local objection block important projects because otherwise, on healthcare, on transport, on housing, on many issues, we will be gridlocked, frozen. And we will be stuck like some developed countries are stuck, where they have no powers to do what is in the public interest.

So we need the spirit of compromise and it is this sort of spirit which has to be part of our maturing democracy. So when you say a democracy is maturing, it is not just the Government taking an attitude or your institutions being right; it is also how the people relate to one another, relate to the Government, relate to the community."

And on to the story......

'No pay cut after 62' deal struck

Almost half of all unionised workers in petrochemical industry will benefit

By Elgin Toh, The Straits Times, 5 Nov 2011

CLOSE to half of all unionised workers in the petrochemical industry will not suffer a pay cut when they are rehired at age 62.

The bonuses of these 2,500 workers will also remain intact.

This departure by 14 oil companies from a common practice was announced yesterday by two unions, the United Workers of Petroleum Industry (UWPI) and the Singapore Shell Employees' Union (SSEU).

The UWPI, the main union in the sector, sealed the deal in a memorandum of understanding (MOU) it signed yesterday with 13 companies.

They have agreed to keep the workers on the same salary until age 65, instead of doing what larger companies tend to do: cut a rehired workers' pay and not give any bonus.

With the re-employment law taking effect less than two months from now, UWPI general secretary K. Karthikeyan said he was extremely satisfied the companies signed the deal even though the law allows for some cuts in salaries.

He added that one main reason for the outcome is that his union agreed more than 20 years ago to move gradually away from the seniority-based wage system.

As a result, the wage differential in the sector between the highest- and lowest-paid workers in the same grade has fallen from 2.6 times in 1986 to 1.5 times.

Singapore employers have typically argued that salary cuts are needed for rehired workers because the seniority-based wage system has inflated the salaries of older workers.

The Singapore Shell Employees' Union told The Straits Times it reached a similar agreement with oil giant Shell a few months ago.