End-of-life care to be more accessible: Gan

Jeanette Tan

Health minister Gan Kim Yong said on Thursday that the ministry would expand its workforce and hospice care services to make end-of-life more accessible to Singaporeans as the nation grapples with an ageing population.

In a speech during the opening of new facilities at Dover Park Hospice, Gan said he was accepting the recommendations of a workgroup to enhance palliative care, demand for which is expected to increase in coming years.

Specifically, the Ministry of Health (MOH) plans to increase levels of training and research, with the eventual aim of ensuring that all healthcare professionals in Singapore are equipped with a certain degree of expertise in palliative care, and expand public education and awareness of the availability of these services for the terminally ill.

“(Hospices) have in recent years witnessed a growing demand from those who have non-cancer terminal illnesses such as end-stage heart, lung and kidney failure,” he said in his speech, noting that non-cancer patients will have increasing demand for such interventions, and hospices are now moving toward supporting this need.

“An integrated system for the delivery of palliative care will ensure that patients are cared for in the most appropriate setting, and allow for seamless care as patients move from one setting to another,” he added.

Upgrading skills

He also said that healthcare professionals across the board should be “equipped with the wherewithal to care for patients with life-limiting illnesses”, adding that the ministry plans to incorporate a greater degree of palliative care training into courses offered in universities, polytechnics and Institutes of Technical Education.

Currently, modules are offered and elements of palliative care education are part of the National University of Singapore’s medicine and nursing degree courses, as well as in Nanyang Polytechnic’s nursing diploma programme, but experts from the Lien Centre for Palliative Care are looking to increase this substantially, to eventually achieve the ministry’s goal.

“This (knowledge and expertise in palliative care) should go down to the GP (general practitioner) level,” said Dr Cynthia Goh, who acted as deputy chair for the workgroup that coordinated and formulated the strategies.

“GPs should be educated to talk to patients about things like pain and end-of-life, and should find out their preferences, in the event that patients can’t say for themselves,” she said.

Minister Gan also noted that Singapore, with its unique culture and value sets, requires an expansion of specialised research done to increase understanding of palliative care here, by learning and adapting models used abroad.

“We also encourage continual research in palliative care service models that can be adapted to suit the unique Singapore context, in terms of our culture and values, as well as our healthcare system and financing framework,” he said.

More outreach

Further, in a bid to advance the ministry’s third goal — to expand public awareness and education on palliative care — the Singapore Hospice Council (SHC) launched a new community outreach program on Thursday that aims to increase public awareness of inpatient, home and day hospice services available for end-of-life patients here.

Its chairman, Dr R. Akhileswaran, said there is an alarmingly low level of public awareness about hospice care, sharing that the figure of 40 per cent of Singapore’s population, based on a survey conducted by the SHC, has remained stagnant over the past four years.

“We hope to link up with different CCs (community centres) to improve awareness, find partners and look for more opportunities,” he said, adding that the SHC plans to organise smaller events on a more frequent basis instead of larger-scale programs that lack follow-ups.

“The demand for hospice care will expand (in the future), and we must be prepared for it to go up,” he added.

There are currently eight hospice bodies in Singapore running hospice services, either in home hospice services, which are free-of-charge, day hospice services, which involve trips to the hospice centre, and inpatient hospice services. Day and inpatient hospice services are offered at nominal fees, which can be modified or waived with means testing.

No concrete details of the plans made by MOH are available yet, however, with the ministry planning to set up an implementation taskforce to iron them out and put these strategies into action.