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Closing Speech By Minister Desmond Lee at the Second Reading of the Vulnerable Adults Bill

1       Mr Deputy Speaker, I thank Members who have spoken passionately on this Bill. Let me now take some time to respond to your questions.

Early identification of vulnerable adults

A       Everyone plays a part in identifying vulnerable adults

2      Some Members suggested identifying vulnerable adults early, to ensure their well-being, to be as proactive as possible.

  • Ms Thanaletchimi and Ms Denise Phua asked what MSF can do to educate our stakeholders and Singaporeans generally, to report suspected abuse cases that they come across.

3       This Bill will only be effective, if all of us play an active part. Let me elaborate.

4       First, everyone should actively report suspected cases of abuse, neglect and self-neglect.

  • MSF launched a three-year "Break the Silence" campaign in 2016 to encourage open conversations about family violence - including abuse of vulnerable adults - and to urge bystanders to action.
  • We went onto social media, radio, cinema, TV, screens, outdoor media and roadshows, to campaign for greater public awareness that family abuse is not a private matter and cannot be tolerated.
  • And Sir, this has gone some way to shape public attitudes towards family violence.
  • In 2017, one in three callers to our hotline who reported family violence-related matters were do-gooders, such as neighbours, friends, and passers-by. This is an increase from one in five, prior to the campaign.
  • MSF has also been training community partners and grassroots volunteers. They are on the ground, and can help us detect formerly 'invisible' cases. We will continue to step up on our efforts in this area, as the work of public education and capacity building can never end.
  • The whistle-blower clauses in this Bill will support both of these efforts.

5       Second, we want front-line staff in relevant agencies to be well-trained and equipped to identify cases of abuse, neglect and self-neglect.

  • These include our Family Violence Specialist Centres (FVSCs) and Family Service Centres (FSCs) as well as medical and healthcare professionals.
  • To Mr Louis Ng's question on their training, MSF has established protocols and training platforms that equip them to handle and detect family violence.
  • These include training modules at the Social Service Institute (SSI), on identifying and managing vulnerable adults.
  • MSF is also building on our existing Integrated Family Violence Manual, which agencies currently rely on to guide their intervention into family violence. This manual will soon also cover the safety of vulnerable adults, so it is a work in progress.
  • To more effectively identify and help vulnerable adults, MSF is currently working with our community partners to co-develop relevant Standard Operating Procedures (SOPs) and assessment guides.

6       Third, the Government must provide avenues for easy reporting, and to react quickly to reports that come in.

  • Ms Thanaletchimi, Mr Louis Ng and Ms Joan Pereira asked about a public hotline where people can report abuse and neglect of vulnerable adults. Mr Ng also asked if every case of vulnerable adult abuse will be reported to the Police for action.
  • Who should the public call if they come across suspected cases?
  • They can alert the nearest FSC.
  • They can call any of the three FVSCs set up by MSF.
  • The numbers for both are available on our website.
  • Or they can call MSF's ComCare Hotline at 1800-222-0000.
  • Where there are immediate safety concerns or danger to a vulnerable adult, the public can call the Police.
  • But not every case of harm to vulnerable adults may warrant Police involvement, at least from the get go. Where the safety concerns are not so clear or immediate, our FSCs and FVSCs will first look into the matter, and alert us at MSF if State intervention is necessary.

B       Mandatory Reporting

7       Mr Seah Kian Peng suggested implementing a mandatory reporting system for stakeholders who interact with suspected vulnerable adults.

8       We did consider this. But we decided against it for now, for two reasons:

  • First, professionals have expressed to us concerns that mandatory reporting laws such as this, especially in the family violence situations, may:
  • Prevent abusers from seeking help for themselves or their victims, as they fear being taken to task.
  • Second, we understand that mandatory reporting laws in overseas jurisdictions have led to over-reporting, many of which were also unsubstantiated.

9       So we prefer, for now, to assure people who step forward, through whistle-blower protection. We will also be developing protocols and guidelines, similar to that used in the child protection sector, to educate professionals and the public on when, how and who to report such cases to. So for those of you who are familiar with the child protection scene, there is the Child Abuse Reporting Guide which we share with our network, pre-schools, schools, clinics, police, medical professionals, hospitals, and using a methodical approach, guide them on what to look out for, what to ask, information to get and who to report to. We are looking at the same protocol for adult abuse.

C       Formation of a National Vulnerable Adults Support Services Association

10       Ms Denise Phua recommended forming a National Vulnerable Adults Support Services Association. It sounds very much like the Community Network for Seniors where we rely on community partners and people on the ground to form networks to look after seniors, and in this case, look after vulnerable adults.

11       We thank her for this suggestion and will certainly explore this in greater detail.

Scope of the Bill

12      Mr Deputy Speaker, I now turn to questions relating to the scope of the Bill.

A       Age limit of 18 years old

13       Mr Ng and Dr Goh asked why the Bill only protects vulnerable adults aged 18 years and older. How about legal protection for those above 16 but below 18, since the Children and Young Persons Act (or CYPA) only covers individuals below 16?

14       First, vulnerable individuals, aged 16 to 18, have some protection under existing legislation, such as the Women's Charter. The Charter protects individuals, regardless of their gender and age, from family violence. A Personal Protection Order (PPO) may be applied for under that Act on behalf of the vulnerable person.

15       Secondly, and probably more importantly, as I have mentioned in my earlier speech, we are reviewing the CYPA to extend statutory protection to those above 16 but under 18, under the Child Protection framework as opposed to the Vulnerable Adults framework.

B       Exclusion of Financial Abuse

16       A number of Members including Dr Lily Neo asked why the Bill does not cover financial abuse, and indeed many of you have come across cases where parents have provided for their children, even sold their homes and helped their children to buy their new homes, only to find themselves ejected out of those homes, or to be financially abused in other ways.

17       I agree with Dr Goh that cases of financial abuse often involve elements of psychological and emotional abuse. So where financial abuse occurs alongside other forms of abuse and neglect that are already covered under the Bill, the State can intervene.

18       There are also some other levers in place to deal with financial abuse against vulnerable adults.

  • In cases where vulnerable adults have been exploited by caregivers, we often do see other family members - such as children - stepping forward to put a firm stop to this. If need be, our social work agencies can nudge next-of-kin to act. So, the family can take action to resolve financial abuse within their own families.
  • In cases where the vulnerable adult lacks mental capacity and the alleged abuser is a donee appointed under an LPA or a deputy appointed by the Court, the Public Guardian may seek a Court order to suspend or revoke his powers to make decisions on the vulnerable adult's behalf, to prevent further abuse. Criminal charges or criminal investigations are not the only way by which the Public Guardian can apply to court to take action against them. We will take cognisance of other facts such as the donee or deputy not acting in the best interest of the elderly person, including financially abusing the elderly person.
  • In fact, family members can also make such an application to Court.
  • If the vulnerable adult lacks mental capacity and has no family members, a deputy may be appointed by the Court to manage his property and affairs, as well as his personal welfare matters.
  • Under our upcoming Professional Deputies and Donees Scheme, which will commence in the second half of the year, a professional deputy can be appointed by the Court to step in.
  • The professional deputy will be subject to the same requirements as any other deputy.
  • If the caregiver who financially abuses the vulnerable adult is neither a donee nor deputy, MSF and our partners will carry out social work interventions and assessments to look at what the situation is about.
  • We may ask the Public Guardian to step in to ask for the Court to appoint a deputy to look into the vulnerable adult's financial situation. Again, this is also open to next-of-kin to do so, to solve this problem within the family.
  • If there is suspicion that offences have been committed, then the Police will also investigate.

19       For now, the Bill's focus is on physical and emotional abuse. Let us gain more experience in operationalising this Vulnerable Adult protection framework, while we continue to study the complex issue of financial exploitation among family members. We have ideas and Members have also raised ideas to us in the course of this debate on protecting our seniors and in many other debates and platforms. Let us continue to look at them and at the appropriate time we will bring them to this House.

C       Sexual Abuse

20       Mr Ng asked why the Bill does not define sexual abuse as an independent head of abuse, and how it considers verbal sexual harassment.

21       Sexual offences are covered, for example, under the Penal Code. If there is conduct or behaviour that coerces or attempts to coerce an individual to engage in sexual activity. This is physical abuse under the Bill and action can be taken.

22       For verbal sexual harassment, this can fall under "emotional or psychological abuse".

D       Emotional or psychological abuse, neglect and self-neglect

23       Ms Chia Yong Yong asked why the definitions of "emotional or psychological abuse", "neglect" and "self-neglect" are definitive, as compared to the definition of "physical abuse" which is non-exhaustive.

24       This is by design.

  • Physical abuse already has a limiting factor, in that the abuse must be physical in nature. There is unlikely to be largely differing views on what would constitute physical abuse.
  • This is less clear for emotional and psychological abuse, neglect or even self-neglect. There may be differing opinions among professionals as well as members of the public on what these would constitute.
  • These definitions are therefore crafted definitively, to provide clarity and certainty on who the powers in the Bill apply to, and limit our discretion on how these terms are interpreted.

E       Psychological assessment

25       Ms Chia also asked why psychological assessment was not included in the definition of "assessment" under the Bill.

26       The current definition of "assessment" allows interviews and examinations to be conducted to determine a person's mental state. This allows psychologists or psychiatrists to interview and examine a vulnerable adult to ascertain if there are psychological concerns.

27       Mr Deputy Speaker, let me take a step back from all the points that have been raised, whether on financial abuse, or on the definitions of abuse, neglect, and self-neglect, and assure Members. That along with the scope the statutory powers that we can exercise under the Bill. The FSC, the FVSC, and MSF are not prevented from social work interventions. They can reach out to the family, the community, the neighbours, and the vulnerable adult. If there is a concern, our community agencies and MSF will respond with social work as our primary tool. But as far as the exercise of these intrusive statutory powers are concerned, we are limited by the definitions under the Bill. Therefore, I hope that you understand that these definitions and the scope of the Bill does not prevent us from acting as we have always done, both now and in the past.

Administration of the Bill

A       Protector's role and function

28       Ms Denise Phua asked about how the Bill will complement existing services, including by APS. Dr Intan asked about the qualities required of Protectors and their roles under the Bill.

29       Sir, APS will assist the Director of Social Welfare in exercising powers under the Bill. Protectors will be senior officers in MSF's Adult Protective Services (or APS), who have suitable qualifications and experience to handle vulnerable adult abuse, neglect and self-neglect cases.

B       APS vs CPS

30       Mr Ng asked about the similarities and differences between APS and Child Protective Service (CPS).

31       The principles guiding APS and CPS's work - are similar in that the best interest and welfare of the vulnerable adult and child must be paramount. Beyond the distinct age groups each Service looks after, APS's work requires them to look into the vulnerable adult's mental capacity so that the client's right to self-determination is upheld as far as possible.

Statutory Powers

A       Thresholds for Intervention

32       This leads me to Ms Phua's and Ms Lim's question on how MSF decides when to intervene, and the rigour of our assessment, particularly when we remove a vulnerable adult.

33       I agree with them that mental incapacity is a continuum, and that mental capacity is not a black and white concept. Indeed, there are good days and bad days.

34       Mr Deputy Speaker, under the Bill, MSF may intervene so long as the adult is suffering or at risk of abuse, neglect or self-neglect, and has physical or mental infirmity that renders him incapable of protecting himself. This will be confirmed by a qualified assessor who can conduct physical and mental capacity assessments. Or it may be different assessors who may come in to do the assessment.

35       Assessing the mental capacity of a vulnerable adult is important, because as far as possible, an adult with the capacity to make decisions should do so.

  • To ensure that we protect his right to participate in the decision-making process, MSF has been working with our partners to develop a mental capacity assessment form.
  • This form sets out certain requirements and checklists that will determine if a vulnerable adult lacks mental capacity. For example:
  • If the vulnerable adult is unable to understand information that is relevant to the decision;
  • To retain that information; or
  • Communicate his decision to others,
  • Then he will be considered as lacking mental capacity.

36       On Ms Phua's example, where the vulnerable adult has mental capacity but shows signs of self-neglect, MSF can intervene to protect him from further neglect.

37       On Ms Lim's examples, MSF will not remove a vulnerable adult without assessing the situation holistically.

  • Where a caregiver is willing and able to look after the vulnerable adult, but lacks the skills to provide adequate support, we will help him enhance his caregiver skills, instead of removing the vulnerable adult.
  • We will invoke removal only when the vulnerable adult's safety and well-being have been compromised or are at risk.
  • Neither will we remove a vulnerable adult because his family members do not have financial means to provide care.
  • In such cases, we will work with our Social Service Offices and other agencies to provide assistance to the family. Ms Lim had given an example which in my view certainly would not qualify for the provisions of the VA Bill to be invoked. This is not the way APS and our agencies should act. It will involve concerns being raised. It cannot be the case that we invoke the VA Bill immediately without considering social work interventions. That would not be in the ambit of how we conduct social work.

38       As I mentioned in my Opening Speech, we will be judicious in how we exercise the powers under the Bill.

  • When we identify a vulnerable adult, the default - where possible - should be to rely on social suasion with the support of his family and the community, because that approach is often more effective and sustainable, internalised by the vulnerable adult and family.
  • Only when this is ineffective, will we rely on the Bill.

B       Power to intervene despite a vulnerable adult's stated wishes

39       Members asked about MSF's power to intervene despite a vulnerable adult's refusal to accept assistance.

40       On the State's powers to remove, Ms Chia said that MSF should be able to remove a vulnerable adult for assessment or placement if there are reasonable grounds to believe that the adult is withholding consent due to some form of coercion. Other members felt we should be more judicious in exercising our powers. Again as Ms Chia pointed out, this is a matter of perspective - whether you are concerned about the needs of the vulnerable adult, or statutory overreach. Both considerations must be balanced, while considering the best interest of the vulnerable adult. And that is enshrined in Clause 4 of the Bill.

41       I agree that a vulnerable adult's right to self-determination should be respected. That is why we hardwired this as one of the key principles in the Bill; and also why there are safeguards in the Bill against unnecessary intervention.

42       But there may be exceptional situations where intervention may be necessary even when the vulnerable adult has mental capacity and refuses assistance.

  • As Ms Chia highlighted, there may be instances where the adult is under duress or pressured by their loved ones to refuse external assistance.
  • I also mentioned the case of Mr Wong earlier, the elderly man who refused admission to a hospital or nursing home to treat his diabetes and wounds. There is a real risk that Mr Wong's life will be in danger in the future, if the State cannot intervene. That would not be right.

43       So, where the need arises, MSF has built in a safeguard. We can only intervene in such a situation after a Court order has been obtained. Where there are reasonable grounds to believe that a suspected vulnerable adult is withholding consent because of coercion or undue influence, for example, we will bring this to the Court's attention. The Court can then make an order for MSF to intervene to protect the vulnerable adult. If there are concerns where it is not expeditious enough, there are clauses in the Bill that allow for ex partes applications.

44       Dr Intan asked if engagement and communication should be applied first before we invoke the law to remove a vulnerable adult; while Dr Goh asked if MSF can exercise some of its powers under the Bill while family and community interventions are ongoing.

  • Let me reiterate that family engagement and social work intervention by community partners, supported by MSF, will be the principal response to cases involving vulnerable adults.
  • But, statutory intervention and family or community interventions are not mutually exclusive. There may be times when a combination is necessary.

C       Removal and Placement

Powers to remove a vulnerable adult

45       To Dr Intan's questions on how a vulnerable adult will be removed from his place of residence if this necessary, MSF is currently developing SOPs to guide the actions of officers when dealing with vulnerable adults, including removal from their homes. Understanding and training are absolutely key.

  • To ensure that the experience does not traumatise the vulnerable adult, MSF will engage the help of support persons, which may include social workers, psychologists and community partners who have interacted with the adult, to assist with the removal.
  • Friends and close family members may also be present as a form of assurance and support for him.

D       Care Arrangements for Vulnerable Adults

46       Some Members raised questions about care facilities and arrangements for vulnerable adults.

47       First, Dr Intan and Dr Lily Neo asked which premises will be gazetted as places of temporary care and protection and how long a vulnerable adult would reside in these premises.

48       Some existing residential care facilities, such as some of the adult disability homes and sheltered homes will be gazetted as places of temporary care and protection and places of safety. A few medical facilities may also be gazetted to cater to situations where the vulnerable adults have clear medical needs.

49       These facilities are intended to protect vulnerable adults who cannot remain safely in their place of residence, while allow them to receive appropriate care.

  • The choice of gazetted care facilities and period of committal will depend on a vulnerable adult's care needs.
  • However, places of temporary care and protection are only meant to house vulnerable adults for an interim period, so that investigations can be carried out and longer-term care plans made. Therefore, the length of stay in these premises will generally not be longer than six months. Again this depends on the specific circumstances of the vulnerable adult and his family, or lack thereof.

50       Second, Ms Phua asked whether these facilities and its staff are equipped to care for vulnerable adults.

51       These facilities have experience providing for residents who are vulnerable, and have in place suitable standards of care to provide for their care and protection.

52       As I said earlier, MSF is also working with front-line officers of relevant agencies to ensure that they have the capabilities to provide support to adults under their care.

53       Third, Dr Intan also asked how the competencies and qualities of a "fit person" are defined, and about the care plan that will be put in place if a vulnerable adult is committed to a facility.

54       "Fit persons" are individuals or organisations whom the Director of Social Welfare thinks are competent to provide care and protection to the vulnerable adult.

  • The main consideration as to whether one qualifies to be a fit person is whether he has the ability to provide the necessary care and protection to ensure the vulnerable adult's safety and allow him to recuperate.
  • Hence, a fit person could actually be a family member or a friend who is willing and able to care for the vulnerable adult.

55       As for care plans, MSF will put them in place to ensure that the vulnerable adult receives the care and protection he requires while in the facility. The care plan sets out a care and recovery framework based on a comprehensive assessment of the vulnerable adult's social, mental and physical state. MSF, together with a Review Board comprising professionals, will review these plans regularly.

56       Fourth, Dr Intan asked whether family members are allowed to visit vulnerable adults in gazetted facilities.

57       Indeed, they are allowed and encouraged to do so. But there are exceptions:

  • For instance, a Court may issue an order preventing the alleged perpetrator of abuse or neglect from visiting or contacting the vulnerable adult;
  • MSF may also limit the contact between the vulnerable adult residing in gazetted facilities and individuals if such contact does not serve the best interest of the adult. Again all these need professional assessment.

58       Ms Lim also provided several suggestions to help vulnerable adults adjust to their new environment. I note her suggestions and we will explore these ideas with the management of the facilities to ensure that these vulnerable adults feel safe and comfortable there even while they are there.

59       Fifth, Ms Thanaletchimi and Mr Seah asked who will bear the costs of care of a vulnerable adult.

60       Families are primarily responsible to provide for their vulnerable members. Hence, if families have means, the costs of placement and any other services or treatment of the vulnerable adult should be borne by them.

61       But we recognise that not all families can provide for their vulnerable family members. In such instances, the State will pay for the temporary placement of these individuals in gazetted care facilities and related costs that may be incurred to ensure the vulnerable adult's well-being. Let me assure this House that a vulnerable adult's inability or his family's inability to pay for such services will not be a barrier to him receiving the necessary intervention, treatment and care.

62       Sixth, Mr Ng and Dr Goh asked about reintegration of vulnerable adults with their families.

63       It is not ideal for a vulnerable adult to stay in a care facility for the long term. We will engage both the vulnerable adult and their families to establish safety and care plans at home. The vulnerable adult will only return home after we deem it is safe for him to do so. We will then work with a community agency to monitor the case and provide necessary support, until it is assessed that no further risks exist.

64       I agree with Dr Daniel Goh that the Government must exercise restraint before interfering with family prerogatives with regard to a vulnerable adult's personal care arrangements. Where possible, MSF will help facilitate the family in caring for their vulnerable members, and this may include the provision of social support.

The role of the Bill in the adult protection landscape

65       Several Members, including Ms Phua, asked the Bill's interface with other legislation.

  • The Bill complements the existing legal framework that protects vulnerable individuals.
  • As the Bill covers a wider scope of vulnerable individuals, there will inevitably be some overlap. But the Bill will ultimately strengthen the current framework by allowing MSF to take a more proactive approach to protecting vulnerable adults.

66       MSF can only do our work when we have the support of the community. We will work with community partners to put in place robust protocols. If practitioners based in community are unsure, they can approach MSF and we will advise them on the best approach to take in relation to that particular case. This already happens on the ground and will remain so, going forward.

A       Role of the donee / deputy (interface with the Mental Capacity Act)

Complaints against donees / deputies

67       I now move to Ms Lim's question on whether a complaint against a donee or deputy should be made to the Director of Social Welfare under the Bill, or to the Public Guardian under the Mental Capacity Act (or MCA).

68       The Bill overlaps with the MCA in that both protect vulnerable adults who lack mental capacity. But both Acts complement each other and strengthen the protection afforded to these vulnerable adults.

  • The Vulnerable Adults Bill allows the State to intervene swiftly to assess and remove a vulnerable adult to safety, and apply for the necessary Court orders to ensure his protection.
  • The MCA then allows the Office of the Public Guardian to intervene, by applying to Court if the powers of the vulnerable adult's donee or deputy need to be suspended or revoked to prevent further abuse of the adult, and if necessary another deputy brought in or a professional deputy (as the case may be).

69       Where such incidents occur, it does not quite matter to whom the complaint about the donee or deputy was made. MSF, including our APS and the Office of Public Guardian (or OPG) will have to assess each complaint holistically before determining next steps.

B       Medical or dental treatment for the vulnerable adult

70       Ms Thanaletchimi asked if there is any conflict between the MCA and the Bill.

71       Let me first clarify that under the Bill, a doctor or dentist may administer the medical or dental treatment to a vulnerable adult, despite the existence of an appointed donee or deputy, if the doctor or dentist is of the view that:

  • Such consent from the deputy or donee cannot be obtained within a reasonable time; or
  • Such consent is unreasonably withheld by the deputy or donee.

72       While a donee or deputy appointed under the MCA can give or withhold consent to treat the vulnerable adult, the MCA already allows for doctors or dentists to override the donee's or deputy's decision. This occurs when the person providing healthcare reasonably believes that treatment is necessary to prevent serious deterioration of the adult's condition.

73       A similar principle now applies in this Bill. MSF has sought to limit a deputy's or donee's powers to consent or refuse treatment for the vulnerable adult under the Bill, as there may be situations where:

  • The donee or deputy cannot be contacted or contacted in time; or
  • And this is pertinent, the donee or deputy is the abuser of the vulnerable adult and thus, out of fear or some other reason, may refuse to give consent to treatment.

74       In such situations, we have allowed for treatment to be administered as withholding treatment would, in such circumstances, go against the best interests of the vulnerable adult.

C       Interface with the Mental Health (Care and Treatment) Act

75       Mr Louis Ng asked how the MHCTA or the Mental Health (Care and Treatment) Act will operate in relation to the Bill.

76       Not all vulnerable adults will fall under the MHCTA.

  • First, not all vulnerable adults suffer from mental disorders. Some of the vulnerable adults that APS sees today may only suffer from physical disability or infirmity, but not a mental disorder.
  • Second, not all vulnerable adults should be admitted to a psychiatric institution when found to be suffering from ill-treatment or neglect.
  • Some with mental disorders may benefit more from living in a gazetted care facility or with a fit person, and may even be able to live alone, as these arrangements may better meet their care needs. Again, it is very specific to the individual's case.
  • Others may actually be able to live alone, and just require protection from the perpetrator. In such cases, a protection order may be applied for to ensure the vulnerable adult's safety.

D       Interface with the Women's Charter

77       Dr Daniel Goh asked about the interface between the Vulnerable Adults Bill and the Women's Charter.

  • The Women's Charter protects individuals of all ages from violence committed by family members.
  • In cases of family violence, individuals can apply for a protection order against the perpetrator under the Charter.
  • But, we recognise that there may be situations where victims of family violence, after prolonged or intense abuse, may become physically or mentally incapacitated, or both.
  • The Bill will be invoked as these victims may no longer be able to protect themselves.
  • As I mentioned earlier, the public, as well as community agencies, can approach MSF and we will review all reports holistically.

Caregiver support

78       Ms Joan Pereira raised the issue of caregiver support.

79       I agree with her that caregiver support is important. Caregivers can face tremendous stress caring for vulnerable family members. And indeed family matters which involve family violence and abuse are not always black and white. In the case of 29 years-old Sam which I described earlier, the vulnerable adult and the victim who was also the cause of the stress to his father.

80       Let me briefly sketch out the options available for caregivers, and I encourage all Members of this House to return to your communities and help to share this information with those who need it. For caregivers of vulnerable seniors, they can reach out to the Agency for Integrated Care as they provide coordinated support to families with vulnerable adults, and help them to access care services and schemes.

  • Caregivers can call AIC's Silver Line, which is 1800-650-6060, for information or referrals to services.
  • Caregivers can also approach the AICareLinks at hospitals and its office at Maxwell Road.
  • These are one-stop resource centres for caregivers to get information and advice on the appropriate services for their loved ones.

81       There are several support services that the Government has put in place for vulnerable adults and their caregivers.

  • First, we have centre-based care services, where seniors can receive care during the day. This includes day care, dementia day care and day rehabilitation services.
  • Second, respite care options are also available so that caregivers can take a break. They can opt to send their family members to eldercare centres for a few hours on the weekends so the caregivers can recharge. For caregivers who need a slightly longer break of several days to a few weeks, they can tap on nursing home respite care.
  • Third, the Caregivers Training Grant supports caregivers, including Foreign Domestic workers, to enhance their caregiving skills.
  • Fourth, the Foreign Domestic Worker Levy Concessions are also available for those who hire a domestic helper at home.

82       For caregivers of persons with disabilities, they can also reach out to SG Enable.

  • Support for caregivers range from day care to long-term residential care. They include the:
  • Drop-in Disability Programme - these are centres located within the community that provide social activities to higher functioning persons with disabilities, who are able to travel to the centre independently, for a few half-day sessions per week.
  • Day Activity Centres (or DACs) which are day programmes to equip persons with disability with daily and community living skills, and provide care relief for caregivers.
  • Adult Disability Hostels (or ADHs) are available as alternative housing arrangements for adults with disabilities who do not require institutional care but are unable to live with their families.
  • VWO Transport Subsidies are also available for persons with disabilities who need to take dedicated transport provided by VWOs to access care services.

Strengthening our care networks for vulnerable adults

83       Sir, the effectiveness of Singapore's adult protection framework is dependent on the strength of our family units in Singapore, and the support of the community.

A       Social-health framework

84       Mr Henry Kwek asked how we can better stay in touch with vulnerable adults.

85       MSF remains committed to working with families and community partners to build capabilities and competencies to support vulnerable adults and detect abuse or neglect.

86       Therefore, while we seek to operationalise the Bill, the Government has already been working on strengthening the social-health integration framework.

  • First, as part of the SG Care movement, MSF will strengthen the role and capabilities of our Social Service Offices over the next five years.
  • We will build even tighter networks with Government agencies, Family Service Centres, VWOs, and other community partners to improve work processes, and share information relating to the needs of our seniors and persons with disability, that will help close the gaps in the adult protection landscape.Second, MSF has transferred our functions under the Senior Cluster Networks such as the Senior Activity Centres (SACs), Cluster Support (SAC Cluster Support), Caring Assistance from Neighbours and other programmes such as befriending services to MOH. This will allow MOH to bring a host of preventive health and healthcare services that will twin the social support provided by the SACs to seniors in rental precincts and studio apartments.These include exercises and nutritional programmes, chronic and functional screening, as well as nursing posts set up at the SACs to help seniors better manage their health conditions.
  • Third, with the merger of the SGO (Silver Generation Office) with the Agency for Integrated Care (or AIC), SGO has trained Silver Generation Ambassadors to:
  • Proactively reach out to, and identify both social as well as health risks and needs amongst our elderly; and
  • Encourage seniors to step out of their homes to participate in preventive health screening and active ageing programmes to draw them away from social isolation.
  • Fourth, MOH will expand the Community Network for Seniors (or CNS) island-wide.
  • Through this effort, AIC links up different Government agencies and community partners to sew up care across both the health and social domains for seniors, especially those living alone.
  • In particular, AIC works with various community-based organisations and grassroots organisations to recruit and train befrienders to look out for seniors living alone in the community.
  • Where SGAs or grassroots leaders identify vulnerable seniors, AIC will coordinate social and health support from various Government agencies and community partners to help them. And there the SSOs and the SGO will work very closely on the ground in the local communities.
  • This includes financial assistance, aged care services and health services.
  • Similarly, if persons with disabilities are identified to have unmet needs, they will be linked up to the relevant agencies, such as SG Enable.
  • Finally, the social care and health care aspects of aged care have become integrated to support seniors, especially those who are frail and/or have weak social support.
  • For example, MOH has integrated home and day care packages, as well as home medical, home nursing, home therapy and home personal care services, to support seniors more holistically so that they can age in place.
  • MOH has also expanded senior care centres into Active Ageing Hubs (AAHs), which not only provides day care and day rehabilitation to frail seniors, but also seeks to engage seniors who are healthy in active ageing programmes.

87       With this framework in place, the Government will be able to tap on the skills and networks in different sectors to ensure a more robust support system is in place for vulnerable individuals.

B       Stronger push for LPA

88       Mr Henry Kwek called for a stronger push for LPA adoption, to prepare our society for potential loss of mental capacity. I agree.

89       The Office of the Public Guardian has embarked on a Business Process Re-engineering (or BPR) exercise precisely to enable us to be future-ready in protecting our seniors who may lose mental capacity. One key objective is to see how we can move towards universal adoption of the LPA, in a citizen-centric yet efficient manner, and adopting a life stage approach. 

90       An inter-agency workgroup has been formed to do this, and will consult the public and stakeholders.

91       And I will ask the workgroup to work with and study Mr Kwek's ideas further.

C       Streamlining the application for deputyship

92       Finally, Ms Lim suggested MSF look into streamlining the application process of deputyship to make it less costly and to make it more expeditious.

93       The Family Justice Courts, the Ministry of Law and MSF convened the Committee to Review and Enhance Reforms in the Family Justice System in January of this year.

94       One of the tasks that we have assigned them is to see how the deputyship application can be made more simple, affordable, and accessible, especially for straightforward and uncontested cases.

  • More details will be provided when the Committee finalises its recommendations.
  • We will also continue exploring ways to ensure that the vulnerable among us are supported.
  • Where eligible, a vulnerable adult could be supported under the Community Kin pilot (Comm Kin pilot), where VWOs can apply for a Court order to manage small and specific sums of an adult's money for his day-to-day needs.
  • This will enable the vulnerable adult to remain in the community with assistance from existing care networks, rather than have to be prematurely institutionalised.

Delay in introducing the Bill

95       Dr Daniel Goh and Mr Louis Ng have asked why it took four years for this Bill to be introduced.

96       This Bill involves intrusive statutory intervention in the realm of family and personal matters, so we did not want to rush this. Indeed, as one member had pointed out, this Bill heralds more conversations in the future about the extent to which the State power should be brought into the realm of the family to enable to intervene and to support. This is not just a Bill that involves operational details, although it does involve quite a lot of that. But we have also had to debate very fundamental questions, both internally and with our stakeholders. We had to consult our stakeholders extensively, and review how past cases were handled, to see where the law needed to come in. We also studied overseas jurisdictions.

97       In drawing up the Bill, we had detailed discussions with public agencies and community partners, such as FVSCs, FSCs, SSOs, hospitals, the Police, the Courts and so on, on implementation, on SOPs, and work is still in progress on that front, capabilities, resourcing and training. Not to mention, the philosophical discussions we have had to have with various partners who were concerned on whether the Bill is sufficiently interventionist or whether it is overly intrusive.

98       And of course, during all this time, it was not the case that vulnerable adults were not support and abuse left unattended.

  • Social work intervention by our FSC, FVSC, SAC (Cluster Support), APS, OPG.
  • With this Bill, we hope to be able to add on the suite of powers that we are seeking your support on.

Conclusion

99      Mr Deputy Speaker, while the Government invests efforts to strengthen the adult protection framework, we will only succeed in protecting vulnerable members if we work with our stakeholder and the wider community.

100       I thank Members and I seek your support for this piece of legislation.

 

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Published On Fri, May 18, 2018
Last Reviewed On Fri, May 18, 2018

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