Professionalising Care Through Public-Private Partnerships
As we evolve into different stages of life, the possibility of requiring some form of care is prevalent. There are enough facts to pressure us to do something now – without hesitation and procrastination, especially when Malaysians are facing longer life spans.
The question we need to ask ourselves is: do we have the basic care necessities? The resources in terms of facilities, manpower and knowledge to care for our loved ones and even ourselves?
To address this question, a Memorandum of Understanding (“MoU”) was signed between University of Malaya and Aged Care Group on 18 April 2017 as both parties come together with a common goal in developing continuum care for the older generation.
Amongst the challenges faced by our ageing demographic, it is the lack of Malaysians who are keen or have the passion to work in the aged care industry that stands out. Rarer still are the care workers and professionals trained with the right skills to fuel this industry.
It should be acknowledged, aged care – no matter the sophistication of it’s infrastructure – is a labour-intensive industry. It carries a human-centred element where experience is etched into the hand that partakes the cause of care. Without that experience from which to learn from, our facilities are but ineffectual.
Beyond being simply a business, aged care is about birthing and nurturing human connections that provides warmth and personal attention, aspects that are important to the care recipient. As such, in order to elevate the aged care industry, there is an incumbent and vital need to professionalise aged care as career employment in care, hospitality and lifestyle living.
To that end, a forum on “How to encourage and attract human capital into the aged care industry” was held and organised by ACG in conjunction of the MoU with UM.
The distinguished panellists who gathered to discuss this issue at the forum were the esteemed To’ Puan Dr Safurah Jaafar, former Director of the Ministry of Health’s Family Health Development Division, Associate Professor Dr. Tan Maw Pin (Faculty of Medicine) of University of Malaya, and Simon Si, Head of Regional Communications of JobStreet. The session was moderated by Carol Yip, CEO of Aged Care Group.
Identify & understand the challenges
Talks regarding the lack of manpower in the aged care industry has always been a constant. The glaring reason that such talks persists is mainly due to a lack of research on the needs and nuances of the factors that would cultivate the necessary human resources in aged care.
As such, the implication to the aged care industry in terms of economic costs and social value to our communities remain unknown to us. It goes without saying that we cannot afford to be ignorant when a thriving aged care business is necessary for the betterment of Malaysia’s ageing population.
According to Dr. Tan Maw Pin, 26% (out of 1000 patients) of those who attended the University of Malaya Medical Centre’s (UMMC) emergency department in 2012 were seniors, which is an alarming statistic.
“During that period, the general senior population over 60 years old in Petaling Jaya district was only 6%. This give us a ratio of 26:6 which is extremely high if compare to United Kingdom, United States and Singapore which is nearly 1.” said Dr. Tan.
Dr. Tan Maw Pin further reiterated that the elderly tends to seek immediate medical attention by going to the emergency department; a distressing figure that shows a huge gap in the delivery of care due to:
- Lack of or inadequate community care services for the ageing community in the neighbourhood; and
- Lack of primary care services by general practitioners and nurses to elderly staying at home.
It also potentially indicates a lack of trained care workers or caregivers/family members at home who know how to take care of the elderly.
Carol further added that UMMC faces a large number of elderly who prolong their stay in the hospital. This is due to a lack of caregivers or family members at home to care for them.
So, how can various players in the value chain collaborate to smoothen the transitory flow of the elderly, starting at the transition from hospitals to their own homes or aged care facility (with quality care services)?
Dr. Tan Maw Pin mentioned that previously, caregiving was carried out by foreign domestic workers. “Until 2 years ago, you could pay foreign domestic workers RM600 to take care of the elderly, and most people could afford it. But things have changed and now I see the opportunity to introduce a structured approach towards caregiving.”
Among the solutions discussed, one such potential approach is to enable the provision of caregiving services at a lower cost by implementing an integrated care framework and training a large pool of care workers with certification.
Dr. Tan stressed that services offered by a caregiver or care worker should not be on a voluntary basis but it should be positioned as a career opportunity, thus creating employment for those interested to embark into the field. It could also provide job opportunities to those who have given up their previous careers to look after their loved ones.
Simon Si also shared an interesting insight: “Jobstreet.com has 30,000 jobs at any one time. With 3 million people on the database, there are only 6 jobs for caregivers out of 30,000 and 4 of them are based in Singapore. There are 360 job offers for nurses but half are for Singapore, and another quarter are for the Middle East market. The salary range for the jobs didn’t cross RM3, 000 monthly”.
With this in mind, Simon stated that the question industry players need to ask themselves is “How can the industry make the caregiving profession attractive in recognizing the fact that such a profession is highly in demand?”
In order to elevate the role of ‘caregiver’ into a career for Malaysians, there must be purpose-built facilities just like hotels and hospitals, with an attractive salary structure to remunerate the care staff.
Other criteria that were discussed amongst the panellists in regards to ‘professionalising caregiving’ involved requiring the aged care facilities to be built to standards similar to that of developed countries and creating certification of caregiving training programmes which are accredited just like a nursing course.
It was also stated that remuneration structures needed to be addressed appropriately to befit the caregivers’ professionalised status.
Currently, there are local caregiving training for individuals or nurses who wish to seek employment overseas, which clearly indicates we are already experiencing a ‘brain drain’ and a shrinking caregiving pool as other countries offer better remunerations.
Celia Yeo from The Victorian State Government, Australia, who look after the services and education sector of South East Asia shared her experiences from Australia:
“Using nurses to do aged care is a waste of resources. In Australia, we have different types of certificate for different users in aged care. You would be specialised in dementia for example even if you are not a nurse.”
Edward Lim (from the audience), an engineer from Vector One proposed the idea of providing caregiving training to kids when they are still at school, “We can encourage students to take the caregiving courses in the school as part of their curriculum and introduce a points system to fulfil the subject requirements via internship. We also can partner with nursing home for their internship.”
It was also noted that Government support plays a crucial role in elevating the aged care industry. According to To’ Puan Safurah, there must be a cohesive effort by various sectors i.e. private sectors, non-profit organisations, the silver community with the relevant authorities to drive a movement action.
Mr. Yoong Yoon-Kit, Performance Management and Delivery Unit (PEMANDU)’s Executive Vice President responsible for the Healthcare portfolio stated that under the National Key Economic Area (NKEA), the business of aged care is mainly meant for the private sector. The government’s role is to facilitate or ensure the smooth progression of the projects by way of giving incentives (for example, from the Malaysian Development Authority (MIDA) etc.
Moving Forward – Taking Action
Wawasan 2020 which encompasses all aspects of life – from economic prosperity, social well-being, world class education, political stability, as well as psychological balance — is only 2 and a half years away, which leaves us little time.
Additionally, we have the Transformasi Nasional 2050 – an initiative to enable Malaysia to achieve ‘developed country’ status within the period of 2020 to 2050. The question is – can the rate of our rapidly growing ageing population afford to wait another 30 years, delaying development of a better aged care framework for ourselves?
Simon Si emphasised the importance of changing the mind set and perception of what ageing means and that building aged care facilities would have to be driven by the private sector. Innovation and technology would also be key to driving industry growth, as well as making it an attractive endeavour.
“It will be expensive and maybe only the top 5-10% of population could afford it, but the spill over effect from it is going to impact the rest of the industry. We need to make it a viable business and attractive for people to join into this industry.
Speaking with the middle-income bracket in mind, To’ Puan Dr Safurah had this to say:
“We can provide quality care by way of community care via day care centres or facilities that will charge lower rates according to the middle-income group’s affordability, while for the poorer ones, NGO’s can help out. By engaging and attracting more players into the industry, there will be economies of scale to deliver quality and affordable care services”.
On the topic of proper budgetary allocation, Dr. Tan stated that “We have enough budget to do the right things, but we keep channelling it wrongly”. Failing to Plan is Planning to Fail.” She emphasised that it is a ‘huge financial issue’ for the elderly that needs to be restructured appropriately as many become bankrupted by checking themselves into a private hospital or hiring 24 hours nursing services at home.
Dr. Tan further suggested that with technological innovation and well-planned care, Malaysians could engage Managedcare (a one-stop care platform) to assist them by coordinating a variety of health related and long- term care services, together with CareTRUSTTM to help individuals to allocate some monies in a living trust to pay for their care needs.
In conclusion, Carol added, “Malaysia is rated as the 6th best place to retire in the world. With the introduction of Malaysia My Second Home Program (MM2H) since 2002 and our own ageing population, we need to build human capital for this billion Ringgit industry— The Silver Industry. Together, we can implement an integrated care framework that is supported by a large pool of trained human resources”.