To meet the needs of an ageing population, the Ministry of Health (MOH) will be upgrading the standards of palliative care services. It is working in partnership with providers and patients, ensuring providers get enough funding support. As of last year, it has built enough capacity to cater for 5,500 people to have palliative care at home.

Now, they are looking to expand the number of inpatient beds for palliative care to 360 by 2020, said Minister of State for Health Chee Hong Tat. Details of the plans will be announced at the MOH's Committee of Supply debate in March.

There are currently 230 inpatient beds for palliative care but there is still a need to increase capacity.

"There is a need to increase capacity, to further raise standards, build capabilities and work together with providers. That is what we have been doing in the past three years and will continue to do so," said Mr Chee.

Steps to meet demand and ensure affordability

The MOH says that it is on track to meet its target of having 6,000 home palliative care places and 360 beds by 2020. This target was set in 2014 when a palliative care plan was published, detailing steps to be taken to meet the demand for and ensure that such services are affordable.

The steps include a new graduate diploma course to train more doctors in palliative care that the MOH will be working closely with the Singapore Hospice Council and other providers in the next few years in order to attract more doctors.

In 2015, the government also allowed people to use more of their Medisave for advanced care services, with no withdrawal cap for those who are terminally ill.

Mr Chee also said that one option to make palliative care more affordable would be to include it under Medishield Life coverage, although that would possibly increase premiums.

"We'll also be providing greater support through subsidies enhancements and also through other types of schemes, for example ElderShield, other types of measures to help patients when they need these services beyond hospital beds,” he added.

More focus on home care services

Assisi Hospice CEO Choo Shiu Ling emphasised that the support of a person at the end-of-life will require a whole team of professionals - palliative care physicians, nurses, social workers, pastoral care staff and music and art therapists.

This limits the amount of patients that can be admitted. For example, the waiting time for admission to Assisi Hospice is about two weeks and on average, patients stay for 22 days.

Therefore the bulk of palliative care services are home care services currently. Government figures show that one in four deaths in 2015 happened at home, while the rest were in hospitals. MOH said it hopes to increase the percentage of people who can pass away at home by promoting greater awareness of palliative care services and advanced care planning. MIMS

Read more:
Palliative care: Why patients deserve the truth
The many facets of rising healthcare costs in Singapore
Training nurses to initiate end-of-life conversations with dying patients

Sources:
http://www.todayonline.com/singapore/palliative-care-enhancements-cards-moh
http://www.straitstimes.com/singapore/health/more-getting-palliative-services