Vulnerable Adults Bill

Mr Deputy Speaker, I thank Members who have spoken passionately on this Bill. Let me now take some time to respond to the Members' queries.

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 the Ministry of Social and Family Development (MSF) can do to educate our stakeholders and Singaporeans generally, to report suspected abuse cases that they come across.

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

First, everyone should actively report suspected cases of abuse, neglect and self-neglect. MSF launched a three-year "Break the Silence" campaign in late 2016 to encourage open conversations about family violence, including abuse of vulnerable adults, to urge bystanders to action. We went onto social media, we went onto radio, television (TV), cinema 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.

Last year, one in three callers to our hotline who reported family violence 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 whistleblower clauses in this Bill will support both of these efforts.

Second, we want frontline 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 on identifying and managing vulnerable adults.

MSF is also building on our existing Integrated Family Violence Manual, which agencies rely on to guide their intervention into family violence. This manual will soon also cover the safety of vulnerable adults – so, 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.

Third, the Government must provide avenues for easy reporting and react quickly to reports that come in. Ms K Thanaletchimi, Mr Louis Ng and Ms Joan Pereira asked about a public hotline where people can report abuse and neglect of vulnerable adults. Mr Louis Ng also asked if every case of vulnerable adult abuse will be reported to the Police for action.

So, 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 necessarily 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 and then we will move in together.

Mr Seah Kian Peng suggested implementing a mandatory reporting system for stakeholders who interact with suspected vulnerable adults. 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 a family violent situation, 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. So, we prefer, for now, to assure people who step forward, through whistleblower protection. So, let us see how it goes.

We will also be developing protocols and guidelines, similar to those 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 Members who are familiar with the Child Protection Scheme, there is a Child Abuse Reporting Guide which we share with our network, preschools, schools, clinics, the Police, medical professionals, hospitals, and using methodical approach, guide them on what to look out for, what to ask and what information to get and who to report to. So, we are looking at the same protocol for adult abuse.

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

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

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

First, vulnerable individuals, aged 16 to 18, have some protection under existing legislation, such as the Women's Charter. The Women's 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.

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

A number of Members, including Dr Lily Neo, asked why the Bill does not cover financial abuse. Indeed, many of the Members have come across cases where parents have provided for the children, sold their homes and helped their children buy their new homes only to find themselves ejected out of those homes, or to be financially abused in any other case. I agree with Assoc Prof Daniel 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.

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.

But 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 investigation are not the only ways by which the Public Guardian can apply to Court to take action, again in 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 this year, a professional deputy can be appointed by the Courts 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, and the Police will also investigate.

So, for now, the Vulnerable Adults 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. Members have raised ideas to us in the course of this debate and the recent Motion on protecting our seniors and, of course, in many other debates and other platforms. As I said, we have some ideas. Let us continue to look at them and, at an appropriate time, we will bring it to this House.

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

Sexual offences are covered under the Penal Code, for example. 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. For verbal sexual harassment, this can fall under "emotional or psychological abuse".

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.

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 as much clarity and certainty as possible on who the powers in the Bill apply to, and limit our discretion on how these terms are interpreted.

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

But, 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 or self-neglect, and assure Members that these scope the statutory powers that we can exercise under the Bill. The FSC, FVSC and our Adult Protective Service (APS) and our Rehabilitation and Protection Group (RPG) units in MSF are not prevented from social work interventions, reaching to the family, reaching out to the community, reaching out to neighbours, reaching out to the vulnerable adult because of the scope of definitions in this Bill. If there is a concern, our community and social work 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, then we are limited by the definitions under the Bill. So, I hope Members understand that these definitions and the scope of the Bill do not prevent us from acting as we have always done, both now and in the past.

Ms Denise Phua asked about how the Bill will complement existing services, including that by APS. Dr Intan Mokhtar asked about the qualities required of protectors and their roles under the Bill. Sir, APS will assist the Director of Social Welfare in exercising powers under the Bill. Protectors will be our senior officers in MSF's APS who have suitable qualifications and experience to handle vulnerable adult abuse, neglect and self-neglect cases.

Mr Louis Ng asked about the similarities and differences between APS and Child Protective Service (CPS). The principles guiding APS and CPS' work are similar in that the best interest and welfare of the vulnerable adult and child respectively must be paramount. Beyond the distinct age groups each Service looks after, APS' 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.

This leads me to Ms Denise Phua and Ms Sylvia Lim's question on how MSF decides when to intervene, and the rigour of our assessment, particularly when we remove a vulnerable adult. I agree with both of them that mental incapacity is a continuum, and that mental capacity is not a black-and-white concept. Indeed, there are good days and there are bad days.

Mr 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 might be different assessors would have come in together and do the assessments.

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 at hand, to retain that information or to communicate his decision to others, then he will be considered as lacking mental capacity.

On Ms Denise 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.

On Ms Sylvia 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 agencies and other agencies to provide assistance to the family.

Ms Sylvia Lim had given examples of cases where a person fulfills the example in the illustration but in her view and certainly in mine, I should not invoke a removal of the adult, for example, if the vulnerable adult is unclothed after a bath but the caregiver needs to go and prepare some medication, for instance. This would not be the way in which APS and our agencies act. It would involve concerns being raised; it would involve interviews, talking to the caregiver, talking to the family members, talking to the neighbours, speaking to the community, speaking to the vulnerable adult. It is not a case of looking at a snapshot of facts that within these 10 seconds, what you did and, therefore, I come and use these powers. It cannot be so. That would not really be within the ambit of how we do social work.

And as I mentioned in my opening speech, we will be judicious in how we exercise the powers under this 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 the family. Only when this is ineffective, will we rely on the Bill.

Sir, Members asked about MSF's powers to intervene despite the vulnerable adult's refusal to accept this assistance. On the state's power to remove, Ms Chia Yong Yong said that MSF should be able to remove a vulnerable adult for assessment of placement if there are reasonable grounds to believe that an adult is withholding consent due to some form of coercion. Other Members felt that we should be more judicious in the exercise of powers.

Again, as Ms Chia Yong Yong has rightly pointed out, it is a matter of perspective, whether you are focusing on the needs of the vulnerable adult or whether you are concerned about whether there is statutory overreach. In fact, both are valid concerns and we want to strike the right balance, avoiding overreach while ensuring that the first and paramount interest is that of the vulnerable adult, as enshrined in clause 4 of the Bill.

I agree that a vulnerable adult’s right to self-determination should be respected. And 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.

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 Yong Yong 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.

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 whether it is expeditiously enough, especially where the case is particularly urgent, then there are provisions in the Bill that allow ex-parte application.

Dr Intan Mokhtar asked if engagement and communication should be applied first before we invoke the law to remove a vulnerable adult, while Assoc Prof Daniel Goh asked if MSF can exercise some of its powers under the Bill while family and community interventions are ongoing. Allow me to 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 and there may be times when a combination is necessary.

To Dr Intan Mokhtar's questions on how a vulnerable adult will be removed from his place of residence, if this is necessary, MSF is currently developing its SOPs to guide the actions of officers when dealing with vulnerable adults, including removal from their homes, where 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 this removal. Friends and close family members may also be present as a form of assurance and support for him.

Some Members raised questions about care facilities and arrangements for vulnerable adults. First, Dr Intan Mokhtar 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. 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. These facilities are intended to protect vulnerable adults who cannot remain safely in their place of residence, while allowing 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 specific circumstances of the vulnerable adult and the family or lack thereof.

Second, Ms Denise Phua asked whether these facilities and staff are equipped to care for vulnerable adults. 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. As I have said earlier, MSF is also working with frontline officers of relevant agencies to ensure that they have the capabilities to provide support to vulnerable adults under their care.

Third, Dr Intan Mokhtar 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. "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. 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.

Fourth, Dr Intan Mokhtar asked whether family members are allowed to visit vulnerable adults in gazetted facilities. 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 assessments. Ms Sylvia 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 even while they are there.

Fifth, Ms Thanaletchimi and Mr Seah Kian Peng asked who will bear the costs of the care of a vulnerable adult. Families are primarily responsible to provide for their vulnerable members. Hence, if families have the means, the costs of placement and any other services or treatment of the vulnerable adult requires should be borne by them. 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 or his family's inability to pay for such services will not be a barrier to him receiving the necessary intervention, treatment and care.

Sixth, Mr Louis Ng and Assoc Prof Daniel Goh asked about reintegration of vulnerable adults with their families. It is not ideal for a vulnerable adult to stay in a care facility for the long term. We will engage both the vulnerable adults 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. I agree with Assoc Prof 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. This may include the provision of social support.

Several Members, including Ms Denise Phua, asked about 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. 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 the 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.

I now move to Ms Sylvia 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 (MCA).

The Bill overlaps with the MCA in that both protect vulnerable adults who lack mental capacity. But both Bill and the Act 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. Where such incidents occur, it actually does not really quite matter to whom the complaint about the donee or deputy was made. MSF, including our APS and the Office of the Public Guardian, will have to assess each complaint holistically before determining the next steps.

Ms Thanaletchimi asked if there is any conflict between the MCA and the Bill. Let me 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 that such consent is unreasonably withheld by the donee or deputy. While a donee or deputy appointed under the MCA can give or withhold consent to treat a vulnerable adult, the MCA actually 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.

A similar principle now applies in the 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 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. 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.

Mr Louis Ng asked how the Mental Health (Care and Treatment) Act (MHCTA) will operate in relation to the Bill. Not all vulnerable adults will fall under 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 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.

Assoc Prof 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 Women’s 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 have mentioned earlier, the public as well as community agencies can approach MSF and we will review all reports holistically.

Ms Joan Pereira raised the issue of caregiver support. 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 Sam, which I described earlier, the vulnerable adult is a 29-year-old man who is both a victim but, in a way, also the cause of the tremendous stress on the part of his father.

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 share this information to those who need it. For caregivers of vulnerable seniors, they can reach out to the Agency for Integrated Care (AIC) 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, 1800-650-6060. This is the AIC's Silver Line for information on referrals to services. Caregivers can also approach the AICareLinks at hospitals and their 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. 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 weekends so that 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, Foreign Domestic Worker Levy Concessions are also available for those who need to hire a domestic helper at home.

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 (DACs), which are day programmes to equip persons with disabilities with daily and community living skills and provide care relief for caregivers. Adult Disability Hostels (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. And VWO Transport Subsidies are also available for persons with disabilities who need to take dedicated transport provided by VWOs to access care services.

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. Mr Henry Kwek asked how we can better stay in touch with vulnerable adults. MSF remains committed to working with families and community partners to build capabilities and competencies to support vulnerable adults and to detect abuse or neglect. 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 SG Cares, MSF will strengthen the role and capabilities of our Social Service Offices (SSOs) over the next five years. We will build even tighter networks with Government agencies, FSCs, SSOs, 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, Caring Assistance from Neighbours (CANs) and other programmes, such as befriending services, over 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 Silver Generation Office (SGO) with AIC, SGO has trained our Silver Generation Ambassadors (SGAs) to proactively reach out to, and identify both social as well as health risks and needs among 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 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 both social and health support from various Government agencies and community partners to help them and, there, the SSOs and the Silver Generation officers 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 provide day care and day rehabilitation to frail seniors but also seek to engage seniors who are healthy in active ageing programmes. With this framework in place, the Government will be able to tap on the skills and the networks in different sectors to ensure a more robust support system is in place for vulnerable individuals.

Mr Henry Kwek called for a stronger push for LPA adoption to prepare our society for potential loss of mental capacity. I agree. The Office of the Public Guardian has embarked on a Business Process Re-engineering (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 LPAs in a citizen-centric yet efficient manner and adopting a life stage approach. An interagency workgroup has been formed to do this, and will consult the public and stakeholders, and I will ask the workgroup to work and study Mr Kwek's ideas further.

Finally, Ms Sylvia Lim suggested that MSF look into streamlining the application process of deputyship to make it less costly and to make it more expeditious. The Family Justice Courts, the Ministry of Law (MinLaw) and MSF had convened the Committee to Review and Enhance Reforms in the Family Justice System (RERF) in January this year. One of the tasks that we have assigned them is to see how the deputyship application can be made simpler, more 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, 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.

Assoc Prof Daniel Goh and Mr Louis Ng have asked why it took three years for the Bill to be introduced. This Bill involves intrusive statutory intervention in the realm of family and personal matters, so we did not want to rush this. Indeed, as a Member has pointed out – was it Assoc Prof Daniel Goh – this Bill heralds more conversations in the future about the extent to which external state power should be brought into the realm of the family to enable, intervene and support. So, this is not just a Bill that involves operational details. It does involve quite a lot of that. But also very fundamental questions that we have to debate 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.

In drawing up the Bill, we had detailed discussions with public agencies and community partners, such as our 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 that we have to have with various partners who are concerned about whether the Bill was sufficiently interventionist or whether it is overly intrusive. And, of course, during all this time, it was not the case that vulnerable adults were not supported and abuse left unattended. Social work intervention by our FSCs, FVSCs, SSC Cluster support, our APS, RPG, Office of the Public Guardian, AIC and the Police continues, as they have always been doing. With this Bill, we hope to be able to add on to that framework with the suite of powers that we are seeking your support on.

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