SPEECH BY MR CHAN CHUN SING, ACTING MINISTER FOR COMMUNITY
DEVELOPMENT, YOUTH & SPORTS, AT CODE OF PRACTICE SEMINAR 2011,
7 OCTOBER AT GRAND COPTHORNE WATERFRONT HOTEL
The Honourable the Chief Justice Chan Sek Keong
Mr Richard Magnus, Chairman, Public Guardian Board
Members of the Public Guardian Board
Distinguished Guests
Ladies and Gentlemen
Good afternoon.
Thank you for taking the time to join us at this forum today to discuss a very important and
pressing issue. It is the issue of caregiving within the framework of the Mental Capacity Act;
that is, caring for those who have lost the capacity to make their own choices and decisions.
We are honoured to have in the audience, members from the legal fraternity, healthcare,
grassroots and social service sectors, and members of the public who are caregivers or
proxy decision makers for someone who has lost his mental capacity.
It is heartening that this forum has attracted such a wide spectrum of participants, from the
Public, Private and People sectors. This reflects the nature of caregiving for a vulnerable
category of individuals – one which is community-based, involving multi-agencies and
individuals who all play distinct, yet equally important roles that contribute to the well-being
and protection of individuals in need.
Caregiving is key in a fast-ageing population
Caregiving is becoming a prominent issue in the context of an ageing population like
Singapore’s. We are one of the fastest ageing societies in the world. Our rate of ageing is
projected to rise from an average of four percent per annum in 2000-2011, to six percent per
annum from 2012- 20201.
With longer lifespan, we will have a higher proportion of Singaporeans living to ages of 85
and beyond. As the incidence rate of dementia increases with age, we can expect a higher
portion of elderly developing dementia in the future. By 2020, one in 12 Singaporeans
above 65 years of age is likely to develop dementia, compared to one in 20 currently2.
A fast ageing population will present unique and diverse challenges relating to the care of
individuals with diminished capacity. Besides professional caregivers, most, if not all of us,
will play the role of a caregiver, in varying degrees, at some point in our lives. What then are
our roles and responsibilities as caregivers; particularly in relation to those who depend on
us to decide and act on their behalf?
Caregiving within the Mental Capacity Act
The Mental Capacity Act, which came into effect in March 2010, now provides a legal
framework for the care of persons lacking capacity. There is also a Code of Practice, which
was drawn up to provide information for the general public, specifying basic guidelines and
highlighting best practices in caring and making decisions on behalf of a person without
capacity. Decision-makers include caregivers, nurses, doctors, donees of a Lasting Power of
Attorney (LPA) and court-appointed deputies3.
1
COS 2011: Minister (PMO) Speech on Ageing Issues
National Mental Health Survey 2004, Ministry of Health
3
Code of Practice, Section 6.2, page 33
2
These guidelines emanate from the basic social value of respect for the dignity of all
individuals which is a key tenet in the Mental Capacity Act.
‘Best Interests’
An important guiding principle within the Code of Practice is the concept of ‘best interests’
‘Best interests’, is a familiar common law concept. But many will likely ask how this can be
exercised practically in relation to caregiving for those without capacity.
Let me illustrate how this concept of ‘best interests’ is practised from the experience of Ms
Joyce Soon who, for the past eight years, has been the primary caregiver for her mother
who suffers from Alzheimer’s disease. Joyce will be sharing her caregiving experience at
one of the sessions later.
Joyce had initially placed her mother in a non-home environment in the hope that she would
benefit from professional care. However, she soon realised that her mother did not settle
well there and looked depressed. She knew that this would only cause her mother’s
condition to deteriorate faster. Hence, instead of making a decision that would likely cater to
her own convenience, Joyce decided that in her mother’s ‘best interests’, she should provide
care for her in a home environment.
Joyce’s experience and the options that she made for her mother’s ‘best interests’ in this
case may not be applicable to all caregiving situations given that each circumstance is
unique.
Determining the person’s ‘best interests’ should underpin all our caregiving approach for an
individual without capacity. ‘Best interests’ as advocated in the new Mental Capacity Act is
part of the protective framework to ensure that the needs and interests of the vulnerable in
our society are protected. It also provides an avenue for caregivers to account for any action
or decision made on behalf of a vulnerable person without capacity.
Conclusion
In a fast ageing population like Singapore’s, demand for caregiving is growing and continues
to evolve. While the Government continues to work with our partners to meet the needs of
the vulnerable in our midst, the community plays an equally, if not more important role.
A successful country is more than the economic success it has achieved. The hallmark of a
truly developed country is the compassion that its citizens have for the needy,
disadvantaged and vulnerable in its midst.
I applaud each of you here who has contributed to caregiving, and play your specific roles
whether at home or professionally. I hope together, we can make a positive difference in the
lives of those in need.
Last but not least, I wish you a fruitful seminar.
Thank you.