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Number of people receiving palliative care increased 30% since 2017

Singapore will be expanding such services and reviewing its financing frameworks to improve access to palliative care. PHOTO: ST FILE

SINGAPORE - The number of people receiving palliative care in Singapore increased by 30 per cent over the past five years, with about 8,800 terminally ill people receiving such care in 2022.

This was announced in Parliament by Senior Parliamentary Secretary for Health Rahayu Mahzam on Tuesday, as she spoke on the Government’s efforts to enhance end-of-life care.

She was responding to an adjournment motion by MPs Ng Ling Ling (Ang Mo Kio GRC) and Yip Hon Weng (Yio Chu Kang).

Ms Rahayu said that as Singapore’s population continues to age, more people here will need palliative care.

Hence the Republic will be expanding such services and reviewing its financing frameworks to improve access to palliative care.

Palliative care should be entrenched as a basic skill set for all healthcare professionals across disciplines and settings, she said.

As such, Ms Rahayu said her ministry is working with the Agency for Integrated Care (AIC) and care providers to equip clinicians with the necessary skills and tools in nursing and home care.

In her adjournment motion on enhancing end of life with choices and dignity, Ms Ng said while a 2014 Lien Foundation survey found that 77 per cent of Singaporeans wanted to die at home, only 30 per cent did. This number rose to 39 per cent in 2022.

She pointed to a Straits Times report on May 1 about a pilot effort by Ng Teng Fong General Hospital (NTFGH) to safely transfer patients who no longer wanted intensive care and wanted to be allowed to die at home.

Commending the medical teams at NTFGH for starting its IAmGoingHome programme in October 2022, she asked if such initiatives could be centralised across public and private hospitals, as well as hospices.

Family doctors could also be included in line with the Healthier SG initiative, allowing more people the choice to “end our walk on this world with dignity, peace and comfort”, Ms Ng said.

In her reply, Ms Rahayu said the Government is working with hospitals and palliative care providers to implement workflows that would allow more patients to undergo a “compassionate discharge” back home.

“This involves, for instance, providing appropriate training and resources, and implementing handover checklists to ensure continuity of care,” she said.

Mr Yip asked how palliative care could be kept affordable, noting healthcare costs “can be a huge burden on families, especially when dealing with end-of-life care”.

Ms Rahayu replied that the overall financing framework for palliative care is also being reviewed to ensure that it remains affordable.

She said Dover Park Hospice and Tan Tock Seng Hospital will co-pilot a single bundled funding rate starting in the second half of 2023, that will empower hospice care providers to decide whether inpatient, day or home hospice settings are most suitable for patients.

This may be progressively expanded should the trial prove successful, and there will be “appropriate safeguards to ensure continued quality of care”.

Noting that caregivers of end-of-life patients often come under tremendous stress, Ms Rahayu said that as of January this year, hospitals can refer patients to a home-based respite care service, which provides them with palliative-trained care staff.

This allows caregivers to rest or tend to other matters while their loved ones are cared for.

A three-year campaign will also be launched later this year to increase awareness and the adoption of tools such as lasting power of attorneys (LPA) and advance care planning, she added.

An LPA allows a person to appoint someone to make key decisions for him should he lose his mental capacity, while advance care planning lets him document his medical treatment preferences in advance and designate someone to decide on medical care for him in the event that he becomes mentally incapacitated.