singapore’s ageing preparedness · 3 engaging minds, exchanging ideas demographic transitions:...

ENGAGING MINDS, EXCHANGING IDEAS

Singapore’s Ageing Preparedness:

Sustaining, Living, Caring

JDC-Eshel 50th Anniversary Conference

15 May 2019

Engaging Minds, Exchanging Ideas2

Outline of Presentation

• Overview of Singapore’s Ageing story

• How Shall We Sustain Ourselves?

• How Well Can We Age-In-Place?

• How Shall We Care For Ourselves?


Demographic transitions: Rapid ageing

Singapore’s Resident Population(1980-2100)

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100

Japan South Korea Singapore Israel

Proportion of population aged 65+

Source: United Nations, Department of Economic and Social Affairs,

Population Division (2017). World Population Prospects: The 2017

Revision, Medium fertility variant estimates for 2020-2100


Shrinking households, families

4.87

3.24

2.00

2.50

3.00

3.50

4.00

4.50

5.00

5.50

1980 1986 1990 1994 1998 2002 2006 2010 2014 2018

Resident Households By Household Size, number of persons

Source: Department of Statistics, Population Trends 2018


A society shaped by migration

3,439,177

112,132

526,619311,264

1,646,457

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

1970 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Singapore's Population by Residency Status 1970-2017

Citizens Permanent Residents Non-PR foreigners

Source: Department of Statistics, Population Trends 2018


Singapore’s Ageing Population Preparedness

• 1980s - Report of the Committee on the Problems of the

Aged

• 1990s - Inter-Ministerial Committee on the Ageing

Population (1999)

• 2000s – Eldercare Masterplan (AY2001-2005) Report;

Committee on Ageing Issues report (2006)

• 2016 – Action Plan for Successful Ageing


Action Plan For Successful Ageing 2016

Ten Focal Areas:


Sustaining ourselves

How can we Age-in-Place

How will we care for each other?

Our Sustaining, Living and Caring themes


How Shall We Sustain Ourselves?


Picture source: rikvin.com


Retaining High Labour Force Participation Rates

Source: OECD Data 2016, Singapore data from Department of

Statistics, and Labour Force Survey 2017

69.5% 69.1%62.1%

46.2%40.8%

26.2%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

Singapore Israel OECD

55-64 years 65-69 years

Labour Force Participation Rates (55-64 and 65-69 year olds)


But older workers tend to be in lower skilled

occupations

0%

5%

10%

15%

20%

25%

30%

35%

40%

Managers&

Administrators

WorkingProprietors

Professionals AssociateProfessionals& Technicians

Clerical SupportWorkers

Service & SalesWorkers

Craftsmen &Related Trades

Workers

Plant & MachineOperators &Assemblers

Cleaners,Labourers& RelatedWorkers

Others

Composition of Singapore's Workforce by Age Range and Occupation

25-54 55-64 65 & Over

Source: Ministry of Manpower, Labour Force in Singapore 2017


Flexible work practices: preferences vs reality

22.3

47.4

20.8

31.3

15.7

24.2

11.7

16.6

22.2

0

10

20

30

40

50

Denmark Netherlands Sweden UK USA Japan S Korea Singapore Israel

Share of employed 55-64 year olds in part-time employment, %

Source: OECD Data 2016, Singapore data from Department of Statistics, and Labour Force Survey 2017


52%48%

61%57%

61%66%

60%64%

74%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Denmark Netherlands New Zealand Sweden UK USA Japan Global Singapore

% employees who would prefer to work from home or other location, but in their job do not have the possibility to do so

Flexible work practices: preferences vs reality

58%

47%55%

51%

65% 68%

81%

68%76%

0%

20%

40%

60%

80%

100%

Denmark Netherlands New Zealand Sweden UK USA Japan Global Singapore

% employees still working in a traditional manner (all ages)

Source: Randstad Workmonitor Global Report 1Q2018


Older Worker Training Participation Rates

59.7%53.9%

50.3%44.7% 41.9%

30.6% 31.2% 33.7%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Denmark Sweden UK Israel USA Japan Korea Singapore

Training participation rates of 55-64 year old workers

Source: OECD statistics, 2016, Singapore data from Ministry of Manpower, 2017

Note: Singapore data for 50-64 year olds


How shall we sustain ourselves?

Promoting Employability

• Retirement and Re-

employment legislation

• Re-skilling and Re-

training

• Job Re-design and

Flexible Work

Arrangements

Income Security in Old-Age

• Mandatory Savings for

Retirement Income and

Medical Expenses

• Social Insurance Schemes:

Annuities, Health and

Disability

• Monetisation of Housing

Equity


More flexibility for re-employment

55 62 65 67

72?

Singapore’s retirement and re-employment age

thresholds since the 1950s


Employability: Skills Upgrading

• SkillsFuture Scheme

– Raising the resilience of the workforce through a

general training fund

• Adapt & Grow Scheme

– Smoothening the transition of workers into new

jobs and industries

• Professional Conversion Programme

– Helping professionals prepare for new jobs in new

industries


Retaining and hiring older workers

• Special Employment Credit

– Employers hiring workers above the age of

55 and earning up to S$4k receive a wage-

offset subsidy

• WorkPro Grants

– Grants to facilitate job redesign, flexible

work arrangements and adopt best age-

management practices


Principles of Singapore’s social support system

Government support

Community assistance

Family as first line of social support

Self-reliance and Individual responsibility

Self-reliance + Many Helping Hands


Pillars of Old-Age Social Security

Home Ownership Healthcare Assurance Workfare Income

Supplement

Income Supplement

for bottom 20-30% of

elderly


Singapore’s savings institution

The Central Provident Fund (CPF)

• Underpins how Singaporeans

finance:

– Home ownership

– Medical bills and healthcare

– Retirement expenditure


The Central Provident Fund system

Income tax-

advantaged

Govt pays

interest on

CPF

balances


Savings accumulation and decumulation

CPF Account Balances (S$M) CPF Retirement Withdrawals (S$M)

0

100,000

200,000

300,000

400,000

500,000

2006 2008 2010 2012 2014 2016 2018

Ordinary Special Account

MediSave Account Retirement Account

S$391

billion

S$126

billion

S$3.4 billion

S$8.6 billion

0

2,000

4,000

6,000

8,000

10,000

2006 2008 2010 2012 2014 2016 2018

Source: CPF Board statistics


Social Risk Pooling: Retirement, Health and

Disability

Retirement income (annuities)

Universal Medical Insurance Cover

Universal Severe Disability Insurance Cover (from 2020)


Social Risk Pooling: Retirement, Health and

Disability

Purchased from own retirement

savings (CPF)

Premiums paid from own MediSave account

Premiums paid from own MediSave account


How Well Can We Age-in-Place?


Picture source: second beginnings, Lien Foundation


Preferred Place of Dying

Where the would want to be cared

for if they were dying Final place of death

Source: Lien Foundation Survey

on Death Attitudes, 2014

70%

10%

8%

2%

1%

9%

Home

Hospital

Hospice

Nursing Home

Others

No preference

77%

12%

7%

2%

2%


Actual Place of Dying

Public Sector Hospitals, 60%

Private Sector Hospitals, 3%

Nursing Homes and Clinics, 2%

Public and Charitable

Institutions, 5%

Licensed Sick Receiving Houses,

4%

At Home, 24%

Other Locations, 2%

Source: Singapore

Demographic Bulletins 2018

• Less than a quarter

of Singapore

residents die at

home

• 69% pass on in

hospitals and

nursing homes


Singapore Australia Japan Korea Israel

Population

Elderly population (aged 65+) in millions

0.5 3.6 33.1 6.6 0.9

Elderly as % of population 12% 15% 26% 13% 8%

LTC Capacity

Total Capacity (beds/places) per 1,000 elderly

51 76 136 72 n.a.

Institutional beds per 1,000 elderly

27 55 24 24 48*

Non-residential places per 1,000 elderly

24 21 112 48 n.a.

LTC Workforce

Total LTC Workers per 1,000 elderly

40 71 59 33 111

Comparative Long-Term Care Statistics

Note: Singapore data is 2016, other countries are 2015. * Israel data on Institutional beds per 1,000 elderly is 2008 (Brodsky et al, 2010) Source: OECD Health Statistics

2018, United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision.


Ramping up Long-Term Care capacity

2,100 3,100

6,200

4,500

6,500

10,000 8,800

9,800

17,000

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

2012 2017 2020

Day care places Home care places Nursing home places

Source: Ministry of Health

Engaging Minds, Exchanging Ideas

From treating medical episodes to care in the

community and at home

Younger populationAcute, episodic

healthcare needs

• Acute-centric care• Acute care as focus of

healthcare delivery

Ageing populationChronic and long-term

healthcare needss

• Patient-centric care• Primary care as focus

of healthcare delivery• Greater focus on

preventive and long-term care


From treating medical episodes to care in the

community and at home


Singapore’s Regional Health Services Model

Moving from being tertiary care-centricity to care in the community

and at home


Kampung Admiralty: a vision of the future?

• 100 apartments for the

elderly

• 2-storey medical centre

with specialist out-patient

care

• Active Ageing Hub, co-

located with a childcare

centre, dining and retail

outlets

• 900-seat food centre

Integrated housing for the elderly with a wide range

of social, healthcare, communal, commercial, and

retail facilities, completed in November 2017.


New living concepts: Heartland Kaki

Source: Second Beginnings: Senior Living Redefined, Chong & Kang, 2018


New living concepts: Giving Campus

Source: Second Beginnings: Senior Living Redefined, Chong & Kang, 2018


City For All Ages (CFAA) Project

• Multi-Generational Family-Friendly Housing

• Subsidies for senior-friendly retro-fits

• Silver Zones (senior-friendly road areas)

• Barrier-free access (lift upgrading, ramps)

Source: Ministry of Health Ageing Planning Office


Care infrastructure in the community

Community Network for Seniors (CNS)

Source: silverpages.sg


How Shall We Care For Ourselves?


Picture source: sg.theasianparent.com


Life expectancy rising 3 years in every decade

61.2

80.7

65.0

85.2

50.0

55.0

60.0

65.0

70.0

75.0

80.0

85.0

90.0

1960 1970 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Life Expectancy at Birth, Singapore Residents, 1960-2017

Male Female


More healthy and unhealthy older persons in

the future

40,000 30,000 20,000 10,000 0 10,000 20,000 30,000 40,000

0

10

20

30

40

50

60

70

80

90

100+

2030

Healthy

males

Unhealthy

males

Healthy

females

Unhealthy

females

Source: IPS projections

• Tapping on the social

capital of a larger pool of

healthy older persons

• Older persons in good

health are a resource pool

adding to the community’s

helping hands


Longevity dividend: ageing well together

• Healthy seniors are a resource with abundant human and social

capital

• Combining data on seniors - both needs and capacity - to tap on

this valuable resource

• Senior volunteerism to boost:

– Active ageing

– Befriending

– Care and Support


Next steps on aged preparedness

• Upgrading the status and skills of older workers (e.g. re-skilling,

professionalisation)

• Aligning financial incentives across the care continuum

• Better monetisation options for savings (e.g. housing equity,

Medisave right-sizing)

• Strengthening community and home care

• Harnessing longevity dividends (e.g. healthy persons aged 65+

caring for each other)

ENGAGING MINDS, EXCHANGING IDEAS

ENDPlease contact Mr Christopher Gee at

[email protected] or 6601- 1418 if

you have any questions.

mailto:[email protected]

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