48 hours in the life of a Malaysian truck driver: From Cameron Highlands...

Getting old and paying for healthcare is an increasing worry for many people around the world, but the elderly in Singapore could be forgiven for thinking their problems would be sorted.

After all, the Republic's healthcare system ranks among the best in the world, delivering basic, affordable treatment for those who qualify. And this is not all on the taxpayer - individuals pay an initial amount and then a national health insurance scheme kicks in.

The compulsory health insurance scheme, MediShield Life, was introduced in 2015 to help with the needs of a rapidly ageing population, as families worried about the large medical bills that can arise when a loved one becomes frail.

But the recent case of 84-year-old Seow Ban Yam revealed that for some, the worry had not gone away.

He was shocked when he received a medical bill of thousands of dollars from the Singapore National Eye Centre (SNEC), and for which he received only $4.50 in insurance payment.

The normally mild-mannered Mr Seow took it upon himself to challenge the bill, writing to the hospital authorities and insurance administrators to get to the bottom of why he was being charged so much.

The explanation that everything was in order merely confused him further. He did not understand why a public institution would charge him $3,664, after government subsidies, when the maximum amount he could claim under MediShield Life for his surgery was $2,800.

Wondering if he had got his sums wrong, Mr Seow wrote a letter to The Straits Times, saying: "Hopefully, you can find my case worth looking into, not only for myself, but also for the sake of the many people like me who otherwise are not aware of what a MediShield Life claim entails.

What The Straits Times discovered, as a result of Mr Seow's case, shocked even those in the upper echelons of the Ministry of Health (MOH) - that at least one public health institution had raised fees to levels much higher than those covered by the national health insurance scheme."We all think that MediShield Life is to subsidise large hospital bills. It is only when one goes through some kind of operation will one know it may not be true."

In Mr Seow's case, the subsidised bill from the SNEC was 50 per cent higher than the claim limit for that procedure.

The wider implication was that thousands of patients in Singapore were probably in the same boat as Mr Seow, getting bills from public institutions which exceeded the claim limits set by MediShield Life.

s a result, the issue was raised in Parliament in January and the Government decided to review national health insurance claim limits every three years instead of five.

There was more good news for those who need the system to deliver basic, affordable healthcare. In March, the SNEC cut its fees for 20 procedures by between 15 per cent and 32 per cent. This could reduce the bill for 14,500 procedures done each year at the centre.

WHY IT MATTERED

What got Mr Seow so riled up and made the issue such a talking point was that when MediShield Life was introduced, the Government made a promise that lower-income people need never fear having to foot big medical bills entirely by themselves for treatment at public hospitals.

The aim was to cover 90 per cent of the bill for 90 per cent of patients beyond the initial deductible and co-payment over that.

Mr Seow's complaint led to the discovery that, in the years since MediShield Life was launched, full coverage had in fact dropped to 80 per cent of patients with large, fully subsidised bills.

This affected patients who need a helping hand - about a third of four million Singapore residents rely entirely on MediShield Life for their health insurance.

HOW THE PROBLEM CAME TO LIGHT

So how did Mr Seow, a retiree who lives in a subsidised government apartment, end up being a healthcare hero for the needy?

It began in 2017 when he went to the SNEC for two operations to unblock the tear ducts in both eyes, in preparation for cataract surgery.

Mr Seow knew he would have to pay 10 per cent of the bill after the deductible, which is capped at $3,000 a year for those over 80, so he expected to pay a total of $3,148.

But he ended up paying $4,472.30 instead, as the bill exceeded the claim limit by $1,472, including fees for room and board, as well as the operation.

The latter alone was limited to $2,800. This capped amount is stated in MOH's table for surgical procedures, though there is no explanation for how the amount is derived.

Said Mr Seow: "The whole idea of MediShield Life is to meet heavy bills. I don't understand why it is limited to $2,800 when the bill is more than $4,000. This defeats the purpose of insurance."

MediShield Life determined it could pay out $3,005, but there was just $5 to take care of after Mr Seow paid the deductible. Of that, MediShield Life paid $4.50, minus his co-payment of 10 per cent.

Fortunately, Mr Seow did not need to take out a bank loan for the overall bill - he could pay the amount from a long-established national scheme where workers pay into designated savings accounts, including one for healthcare called Medisave.

John Q:I am not guna bury my son, my son is guna bury me!

As Neil Parker dragged his broken body along an isolated Australian bush track, thinking he would likely die out there, he channelled his mind on reconnecting with his estranged son living in New Zealand.

The seasoned bushwalker, 54, had broken his leg and wrist after he fell six metres from a waterfall while hiking alone at Mount Nebo, north-west of Brisbane, on Sunday.

His mobile phone was drenched and unusable after he plunged into the water, and he had given his personal alert device to his ex-wife.

Speaking from his hospital bed on Wednesday, the day after he was airlifted to safety, Parker said he knew his only chance of survival was to fasten a splint from his walking poles and drag himself to safety.

"I caught myself the first time as I started to slide but I had too much momentum and over I went.

"I started sliding down the face of the rock and I slid about 20 foot, cartwheeled then slammed into the rock then landed into the creek at the bottom.

"Straight away I thought, 'Now I am in a lot of trouble, nobody knows where I am, I don't have a personal location beacon'."

Parker had spent seven years as an SES volunteer and had worked on several rescues himself.

"I knew where I was located, there was going to be no way they could find me," he said.

"Inch by inch" he began to drag himself along the three-kilometre track to a clearing where he thought helicopters would be able to spot him.

"My left foot, the bottom, just above the ankle - clean snap in half - so the whole bottom of my leg came loose," he said.

"Legs are very heavy when they aren't connected to anything and trying to pick it up over rocks ... I would get about a metre, metre-and-a-half each time before I would have to stop and take a break.

"What took me 40 minutes to walk up, took me two days to crawl down."

With just a handful of nuts, a protein bar and some liquorice to eat, Parker spent two nights out in the bush.

"At night-time I was sleeping on rock, I had been crawling on rock all day - everything was hard so most of the pain I was going through was constantly being on hard rock.

He said he did not actually get much sleep thanks to his broken leg continuing to spasm in the cold.

"I think I have a very high [pain] tolerance, I had no issues with pain while I was crawling around, I didn't feel any discomfort or that while I was crawling but that could have just well and truly been adrenalin pumping."

The relief finally kicked in after he was spotted by a rescue helicopter on Tuesday afternoon.

"I had had enough of laying on rocks and I just started imaging nice fluffy pillows," he said.

As to what kept him going, he said it was sheer determination to see his sisters, children and ex-wife.

"The family connection, wanting to get back and let them all know I was OK kept driving me," he said.

"[My sister] rang my kids in New Zealand and my son said he would fly over next week.

"I have been disassociated with him for the last two years, so I only just came back together with him four or five weeks ago," he said, tearing up.

"Gee, I wanted to talk to him.

"So that was the main reason, I wanted to get home to my kids."

He was airlifted to the Princess Alexandra Hospital and credits his survival to his preparedness and the rescue mission mounted by his family with the support of the Brisbane Bushwalkers community, whose members set out on Monday to find him.

Orthopaedic surgeon Nicola Ward said Parker would remain in hospital for at least the next two weeks and was expected to go into surgery on Wednesday afternoon.

true or lies?

The way Dr Sean Ng Yung Chuan treated a patient who died following total knee replacement "goes beyond mere human error", said the coroner at the conclusion of a seven-day hearing.

State Coroner Kamala Ponnampalam said on Monday (Sept 16) that a coroner "does not make a determination of guilt or negligence or attribute legal or moral culpability".

Nevertheless, she flagged Dr Ng's behaviour which "demonstrated a clear departure from the standards expected of a physician who had primary care of a post-surgery patient".

She criticised the doctor for failing to make detailed notes or to hand the patient over to another specialist when he had planned to travel after operating on her. If he had done so, the other specialist might have noticed tell-tale signs that something was wrong, and taken action earlier.

Dr Ng, who has been a practising orthopaedic surgeon since 2011, said he had told Mrs Yuen about the conference in Tokyo and had suggested performing the surgery upon his return.

“According to Dr Sean Ng, Mrs Yuen was quite insistent on having the surgery done before his departure but did not say why,” the coroner recorded.

Dr Ng said that prior to his departure, he had checked how Mrs Yuen was progressing and was told “everything was fine”. He said it was not mentioned to him that her lower left limb was cold.

Dr Ng said that while he was in Tokyo, ward nurses told him Mrs Yuen complained of leg numbness and he called the anesthetist who assisted him on the knee replacement surgery Dr Adrian Ng to review her. Dr Adrian Ng told him to continue with his trip, Dr Ng said.

When the elderly woman’s condition worsened, the surgeon said he cut his trip short and returned to Singapore on Nov 5, 2016.

“Dr Sean Ng stated that he did not hand over care of Mrs Yuen to another specialist during his absence because there were no post-surgical complications prior to his departure and her progress was acceptable,” the coroner wrote in her findings.

“He added that he was unable to comment if there would have been a significant difference to life and death if the vascular damage had been identified and managed intra-operatively.”

In addition, Ms Ponnampalam found that Dr Ng had documented his reviews of Mrs Yuen's condition retrospectively in the case notes, instead of at the time of the reviews on Nov 1, 2016 and Nov 2, 2016.

"The making of retrospective case notes is a clear contravention of SMC guidelines," the coroner wrote.

According to the coroner’s report, the hospital also had concerns about the nurses who cared for the patient, with one being given a “verbal warning” for having documented circulation as normal in the care pathway chart when she did not personally assess the patient.

In her conclusion, Ms Ponnampalam said the evidence showed that an artery and vein were likely transected during the initial knee replacement operation conducted by Dr Ng, and that although a “relatively rare complication”, it was a known risk and should have been accounted for during the surgical approach.

Ms Ponnampalam also said: “Dr Sean Ng leaving the country on post-operative day two after performing a major surgery with a failure to hand over the patient’s care to an appropriate specialist was injudicious and may have resulted in the delayed recognition of the ischaemic limb.”

“The decision not to arrange for a covering specialist during his absence was short-sighted,” she said.

The coroner also said that the documentation of Mrs Yuen’s post-surgery care was “less than ideal” and “found to be unreliable” by the medical expert.

There was a “dire lack of details” in Dr Ng’s notes and that the retrospective entries days after were “unhelpful” as the patient’s condition had “severely deteriorated”.

The nurses’ notes were also “brief and in some instances, inaccurate”, and one nurse had relied on Dr Ng’s observations instead of making independent checks.

Ms Ponnampalam noted that an inquiry is not meant to make a determination of guilt or negligence, but it does assess "if an act has fallen short of reasonable standards".  

She said there was no basis to suspect foul play.

A scan found that severed blood vessels had caused an ischaemic limb, which is a lack of blood flow to a limb.

An emergency operation was conducted successfully but Mrs Yuen continued to deteriorate. Dr Chin decided on emergency high above knee amputation to save her life but post-surgery, Mrs Yuen went into cardiac arrest and developed multi-organ failure.

How Nurse Helps Chinatown's Ailing Elderly Stay Out Of Hospital

When Richard Chew woke up one Thursday morning feeling “a weakness” on the right side of his body, he didn't think it was anything out of the ordinary.

“I tried to grab onto my bed but I slipped to the floor,” the 57-year-old retiree recalled.

“So I told my wife, I think I'm still quite okay,” Mr Chew said matter-of-factly. “Then she said, okay you take care, and went on to work.

“I was thinking, for whatever reason, I have this weakness and it may go away at night.”

But when his wife came home from work that evening, she noticed that the features on the right side of his face “were twisted”, and his speech had become slurred.

These were the typical signs of a stroke.

“We didn't know how to react to this," said Mr Chew. "Of course, the first thing is to go to the hospital. But should we go straight?”

Eventually, they decided to go to Singapore General Hospital’s accident and emergency department (A&E), but in their own car, driven by Mrs Chew.

When they reached the hospital, they had to register and go through triage, before the A&E nurse found out that Mr Chew has had a stroke and immediately activated the acute stroke team.

By the time the team attended to Mr Chew, more than 12 hours had passed since the time he woke up with that tell-tale "weakness".

Due to the delay, the team couldn't administer treatments which would have helped him if they were administered within six hours after onset of the symptoms. He was sent to the stroke unit for monitoring to prevent further complications. 

Fast forward three months, Mr Chew is now wheelchair-bound and unable to use cutlery with his right hand.

It was only after his experience that he realised that he had made two mistakes - not going to the hospital immediately, and going to the A&E by car.

While more patients are arriving at the hospital "early enough" for timely treatment since the first Spot Stroke campaign in 2016, only around 50 to 60 per cent came in by ambulance

72-year-old Tan Mong Huat was luckier than Mr Chew.

Last year, the former Grab driver was ferrying a passenger from Jurong to Labrador Park when his vehicle crashed into a lamp post.

"At first I thought my car tyre was punctured," said Mr Tan. "But luckily my customer was alert and saw that I might have (had) a stroke. He asked me not to move and immediately called the ambulance."

SCDF paramedics arrived within 10 minutes and he was sent to National University Hospital where he was given the clot-busting medication.

As a result of that timely intervention, he suffers no side-effects or disability from the stroke. 

When asked what he would have done if he were alone, Mr Tan replied: "I would not know, that was the first time I suffered a stroke and I don't know the symptoms."

"I want to express my heartfelt gratitude towards the passenger who called 995, the SCDF paramedics and the hospital’s acute stroke team. Their actions had contributed to a better outcome for me and my condition would have been more serious without their prompt response."

"TIME IS BRAIN"

​​A stroke occurs when a part of the brain gets damaged due to an interruption in its blood supply. When brain cells die because they do not receive oxygen from blood, it is irreversible.

Stroke remains the fourth leading cause of death in Singapore and one of the top contributors of adult disability.

In the treatment of acute stroke, the team’s priority is to save the brain tissue that hasn’t died, which in turn saves body function and the patient's quality of life in the long run.

“If you ask me, the better term is time is brain," said Dr De Silva. 

The more time we lose, the more brain we're losing.

For the team, the clock starts ticking not when the patients passed through the doors of the hospital, but when they first experienced the symptoms.

The most common signs of a stroke are sudden drooping of one side of the face, weakness of one side of the body and difficulty speaking or understanding speech.

There's a bit of “detective work” involved in pinpointing when the symptoms first appeared, said NNI Advance Practice Nurse Il Fan.

“The patient’s history is the most important thing that we want to find out when they arrive," said Il Fan. "Sometimes if patients come in unable to talk, we go to the extent of checking their phone to trace their last conversations and find out (the last time) they were well.”

"If the SCDF (paramedics) can actually give us a lot of information then it will be helpful, because sometimes even though passers-by witness it, they don’t come together with the patient to the emergency department.”

“When we receive a notification that there is a stroke case (inbound), we will go down to the emergency department,” said Il Fan as she quickened her pace to the basement where the resuscitation area is located.

Just because the Singapore Medical Council (SMC) is the professional watchdog does not mean that it can act with "absolute impunity", the Court of Three Judges ruled on Wednesday (Sept 4) when it upheld a disciplinary tribunal's decision to make the SMC pay the legal costs of a high-profile plastic surgeon.

The SMC had charged him for using a patient's pictures and medical information without her consent, but the disciplinary tribunal, in finding him innocent, said the complaints were "vexatious and baseless" and told the SMC to pay the surgeon's costs for the hearing.

The SMC did not dispute his acquittal, but appealed to the Court of Three Judges against having to pay the surgeon's legal costs. It now also has to pay $20,000 to cover his costs for the appeal.

The plastic surgeon was not named in the judgment.

The surgeon, who runs his own clinic, had successfully treated the woman with Botox for enlarged parotid glands from 2008 to 2013.

In 2014, she filed a complaint against him for using her "unanonymised photographs" in a chapter of a book and in at least two medical presentations.

The surgeon told the SMC's Complaints Committee that he had obtained her written permission for the use of the materials.

Almost two and a half years later, the SMC informed the surgeon it was bringing charges against him.

But, satisfied that the surgeon's conduct met approved standards, the disciplinary tribunal acquitted him of all charges. It also faulted the SMC for its lack of documentary evidence to back up the patient's claims.

The Appellate Court noted that the SMC was aware that the patient had signed a written statement allowing the use of her photos and to describe her case in medical/scientific publications.

The surgeon told The Straits Times that he used them in a technical book and was not paid for his contribution.

The SMC's case rested on the patient, her husband and one expert witness who did not have the professional experience to back his opinions. The court said the SMC should, "at the very least", scrutinise if its expert had the relevant expertise.

It noted that the tribunal saw fit to "express its strongest condemnation" against the patient and said: "This is by no means a common finding and not one that a court of a tribunal would make lightly."

The tribunal found that not only were her allegations false, but the patient and her husband had also lied in other areas. She had claimed to be a naive homemaker but the tribunal found her "a sophisticated, capable and highly educated professional with a mind of her own".

The surgeon told The Straits Times the case had been "a most unpleasant experience".

He added: "But the judgment by the disciplinary tribunal and the High Court has given me great faith in the disciplinary process and in our legal system."

Her workload would remain the same. But as Margaret (not her real name) approached the statutory retirement age of 62 in 2012 — the same year that re-employment laws took effect in Singapore — the then-civil servant had to sign a new one-year contract with her employer. It entailed a pay cut, a downgrading by one job grade, and a S$500 medical claim limit annually.

While she felt that the terms were not well justified, she felt satisfied enough with them to sign the contract, mindful of the horror stories which she had been hearing about re-employment terms being offered to other employees of her age.

Margaret, now 69, said that at that time, she knew of older workers in the public service who had to take a more drastic pay cut after being downgraded by several rungs, and of supervisors having to step down and work under subordinates although they had not expressed any plans for retirement.

Much has changed since in the public service: Since July 1, 2017, wage adjustments were done away with, and the large majority of re-employed public officers received “no pay cut”, the Public Service Division (PSD) said in response to TODAY’s queries. 

Public officers will continue to receive their last drawn salary if they are re-employed at the same grade, and those who are re-employed are also offered the “prevailing leave and medical benefits schemes, which are aligned to market practice”, PSD added. 

In the private sector, however, some older workers continue to get the short end of the stick.

Take Pamela (not her real name), 67, for example.

Until last year, she had worked as a head of department at a local bank.

Strictly speaking, her employer had abided by the Government’s re-employment rules, which require organisations to offer re-employment up to a stipulated age to eligible employees who reach their retirement age.

But it was the way she was treated towards the end of her second one-year contract with the bank — she was asked when she would be “calling it a day” — that left a sour taste in her mouth.

While the question was “subtly and politely put across”, the “hint was pretty strong”, she said. She left the bank as she felt unwanted by her employers. 

For some older workers, subtle discouragement may come in the form of new employment terms.

A 61-year-old working at a multinational manufacturing firm, who declined to be named, told TODAY that despite having worked at the company for more than four decades, the number of days for her annual leave will be halved from 24 days to 12 days — same as what a fresh hire gets — under her new contract which will take effect in a few months when she turns 62.

Similarly, a 67-year-old who worked in port operations said he was given a S$200 cap for yearly medical claims under his re-employment contract. Previously, there was no such limit as far as he knows.

These employees were among more than a dozen older workers interviewed by TODAY.

To be sure, the employment rate of older workers has gone up since re-employment laws came into force, based on government data. Still, the experiences of those interviewed suggest that mandating employers to rehire eligible workers once they reach retirement age is a work in progress, and it is more often than not an unpleasant experience for these workers — even though the policies aim to protect them and allow them to continue working if they wish to do so.

This is especially so when the older workers feel that they remain healthy and able to perform at the same — if not higher — levels compared with their younger colleagues.

In this regard, the public sector, as well as a few private sector firms, are leading the way by re-hiring older workers, without any changes to their roles and employment terms including salaries.

But the positive examples are too few and far between, as TODAY’s interviews with the older workers show.

Still, experts pointed out the constraints faced by businesses — in particular, the seniority-based wage system that is entrenched in many companies in Singapore.

Workers here expect wages to go up with each passing year, noted Assoc Prof Walter Theseira, a Nominated Member of Parliament (NMP) and economist with the Singapore University of Social Sciences.

As a result, over time, there could be a “mismatch between pay and work output” among older workers, he said.

“At some point, work output may plateau or even fall, but pay keeps going up,” he added.

“It is common to paint this as a problem of unfair employers… It is also unfair to younger workers if they produce more output but they are paid much less than a more senior worker,” said Assoc Prof Theseira.

But is there scope to finetune the re-employment laws — say, for example, mandating that the terms offered to the older workers must take into account their health and work performance?

It would be unwise to make the laws more rigid, said several MPs who cautioned that doing so could backfire and put businesses off from hiring older workers.

Pasir Ris-Punggol GRC MP Zainal Sapari, who is also assistant secretary-general of the National Trades Union Congress (NTUC), reiterated that the signing of a new contract during re-employment “gives the flexibility for companies to offer a package that is sustainable for them and at the same time, allow workers to continue”.

Businessman Douglas Foo, who is the founder and executive chairman of Sakae Holdings, noted that should the flexibility be taken away from employers, operational costs could rise.

“That makes our country much less attractive for others to come and invest in the backdrop of a tight workforce,” said Mr Foo, who is also an NMP.

Singapore’s retirement and re-employment ages are back in the spotlight following Prime Minister Lee Hsien Loong’s announcement in his National Day Rally speech that the retirement age will be raised to 63 in 2022, and eventually to 65 by 2030.

The re-employment age will be increased from 67 to 68 in 2022, and eventually to 70 by 2030.

With Singaporeans having the world's longest life expectancy in 2017 with an expected lifespan at birth of 84.8 years, the changes are aimed at helping older workers to continue working and to be more financially independent.

WHAT OLDER WORKERS WISH FOR

The re-employment age — a concept pioneered in Japan — is viewed as a better alternative to raising the retirement age, given the concerns by businesses that a higher retirement age might affect costs and productivity.

When it was introduced in Singapore seven years ago, the objective was not only to protect the interests of older workers but also to create a pro-business environment that would ultimately safeguard jobs.

Older workers, however, told TODAY that they wish their employers can implement the re-employment policies with “a little more heart”.

Pamela said: “Do companies really subscribe to the Government’s thinking and the spirit of re-employing workers, or do they just do it because they are obliged to?”

She could sense the bank’s half-heartedness when it did not offer her any alternative positions, or at least seek out her preferences on continued employment, even though she had worked in the bank for nearly 30 years.

“They only think about crafting career paths for the young ones, but we (older workers) deserve a bit of attention too. The attachment (to the bank) is there. We have a proven track record,” she said, adding that the bank’s human resource (HR) department should have been more proactive in looking for alternative roles for her.

She also lamented how older workers in the bank would only find out whether their yearly contracts would be renewed for another year on their birthday month.

Tripartite guidelines encourage employers to inform employees who do not qualify for re-employment at least three months before retirement, so they can better prepare for retirement or seek other employment opportunities. However, this procedure is not always followed, based on TODAY’s interviews with older workers.

Unsurprisingly, those who were re-hired by their organisations on the same terms, with their roles unchanged, are happy to continue working as long as their health permits.

One of them is Mr Abdul Aziz Abdullah, 64. The head of the logistics and hospitality team at Maybank has been working with the bank for 41 years and counting.

Despite reaching the retirement age a couple of years ago, he continues to lead a team of six relationship managers to manage a loan portfolio comprising hotels, foreign worker dormitories, and office buildings.

“It has never crossed my mind to retire from work when I turned 62 because I still have the passion for my job,” he said.

Likewise, Madam Noreen Wee, 63, is still going strong as the lead writer of insurance policy contracts at Prudential.

In October last year, the insurer abolished the retirement age for its employees, allowing its 1,100 workers to decide when they want to retire.

Mdm Wee, who intends to work till 70, described it as liberating not having to fear when she would be made to call it a day because of her age.

HOW RE-EMPLOYMENT CAME ABOUT  

Given the demographic changes and increasing life expectancy, Singapore’s policymakers first started talking about re-employment in 2007.

It took five years before it became law in 2012, making it mandatory for employers to offer re-employment for workers who have reached the retirement age until they turn 65. This was raised to 67 in 2017.

Meanwhile, since its legislation in 1993, Singapore’s retirement age has been raised only once, from 60 to 62, in 1999.

Back in 2010, then-Manpower Minister Gan Kim Yong said the aim of Singapore’s re-employment laws was to raise the employment rate of older workers, by giving them a “flexible and effective” way to work for as long as they are able to.

At the same time, the laws have also been designed to be pro-business.

Mr Lim Swee Say, who was appointed Manpower Minister in 2015, said in 2017 that tripartite partners — the Government, employers and the unions — had hit the wall after raising the retirement age in 1999. Employers were objecting to a further increase due to the impact on their businesses, and younger workers were also against it because they did not want their career progression to be stalled, Mr Lim said.

So, Singapore began looking to Japan and its re-employment age. “When you raise the retirement age, the expectation is ‘same job, same pay’ ... When Japan introduced the idea of re-employment age, the concept is ‘not necessarily the same job, not necessarily the same pay’,” Mr Lim told Parliament during the 2017 debate to raise the re-employment age from 65 to 67.

VARIED PRACTICES

Observers said that some employers have taken advantage of the flexibility accorded to them, to the detriment of older workers.

Mr Foo criticised such a practice as “an abuse of the whole spirit of what this policy is about”.

Employers should instead make use of the flexibility to tide over an economic downturn or stay agile in the face of disruptive innovations, said Mr Foo, who is also a vice-president of the Singapore National Employers Federation (SNEF).

Still, Mr Alexander Melchers — Mr Foo’s fellow vice president at SNEF — felt that the adjustment of some employee benefits such as annual leave days is fair.

These benefits may be tied to seniority, and some employers may adjust it to make it more equitable with other employees, he said.

“It is not about ageism but about ensuring the employability of our workers in an ageing society,” he added.

TODAY’s checks with several employers revealed varying approaches when it comes to their re-employment policies.

Prior to the re-employment laws coming into force in 2012, the public service had taken the lead by first introducing the Public Service Re-employment Guidelines a year earlier.

Back then, the Public Service had made provisions for wage adjustments in order to encourage private sector employers to re-employ their employees, PSD said.

This was aligned with the national tripartite guidelines on re-employment at that time, it added.

Over the years, it monitored market practices and gathered feedback from the public agencies and the public service unions. Subsequently, PSD decided to remove wage adjustments for all officers by July 1, 2017.

Nevertheless, PSD said that officers “may or may not do the same job when they are re-employed”, citing changes to job scope or the agencies’ needs as the public service transforms itself and builds new capabilities.

Under the PSD’s re-employment guidelines, public agencies will consult officers on re-employment at least six months before retirement in an “open discussion” between supervisors and officers. This is to help “manage expectations as well as understand officers’ concerns and preferences on job arrangements, training opportunities, wages and benefits”, PSD said.

It added: “Any work arrangement, including any changes, are mutually agreed to by the officers and their agencies taking into consideration the officers’ preferences and the availability of suitable positions.”

In cases where the jobs are no longer available, public agencies will provide support to affected officers in terms of reskilling, redeployment, and employment facilitation.

Over in the private sector, TÜV SÜD PSB said it is committed to not cut the pay of any re-employed worker. It also offers options such as part-time employment should older workers wish to reduce their workload.

At CapitaLand Group, its head of group human resources Angeline Oh said its older workers could either work in the same capacity or take on a redesigned role which comes with flexible hours or reduced scope.

CapitaLand, which is a real estate developer, currently re-employs more than 30 individuals. About five employees stayed beyond the mandated re-employment age of 67 years old, Ms Oh added.

Mencast Marine, which makes and repairs ship propellers, re-employ older workers on one-year contracts, renewable up to age 67, with the same employment terms as before. They comprise 7 per cent of the firm's employees. Nevertheless, the firm noted that the older workers’ ability to pick up new skills, such as advanced technical training, “remains a challenge”.

Deloitte’s talent leader Seah Gek Choo said the big-four accounting firm will first hold discussions with interested retirement-age employees on their role, salary, benefits and other employment terms.

Following that, the firm “will look at our business needs and the interests and skills of the individual”, she said. Eligible employees will be offered a yearly contract until they reach 67, or beyond, provided that they show “good work performance” and are certified “fit for work”.

Deloitte currently has about 25 employees on re-employment contracts. Three of them are above 67.

While Ms Seah believes most employers do see the advantage of re-employing older employees, “cost is a consideration”, she said. Government schemes such as the Special Employment Credit provide employers with support to hire older Singaporean workers, but these are “temporary”, she pointed out.

Group insurance for employees also stops at age 70, so organisations “do not have the incentive to employ older workers beyond that age”, she added.

Over at DBS Bank, workers seeking re-employment can choose between working full-time with no pay adjustments, working part time, and taking up a different role with the bank.

Since 2012, the bank has seen a “three-fold increase” in the number of workers aged 62 and above, said Ms Theresa Phua, DBS’ Singapore HR Head.

Over 95 per cent of the bank’s older workers chose to work full-time, while the others opted for flexible work arrangements.

OCBC, meanwhile, said it takes a “long-term view” on employees. It initiates conversations about retirement much earlier, compared to most companies, through a programme catered to employees aged 40 and above.

Through the programme, the older workers are given the option to participate in workshops on financial planning or health and wellness. They can also take part in reskilling or upskilling courses, which could potentially help transition them to other areas of interest, OCBC head of HR planning Jacinta Low told TODAY.

OLDER, BUT ‘ABLE AND WILLING’ 

The number of older workers in Singapore who are able and willing to continue working is set to increase, experts have said.

There is a gap of 12.2 years between the average number of years which Singaporeans are expected to lead healthy lives — known as the Health-Adjusted Life Expectancy (Hale) — and the current retirement age of 62.

Before the recent announcements, retirement age — meant to prohibit employers from dismissing workers younger than 62 due to their age — had remained unchanged for two decades. But based on the Hale benchmark, the average Singaporean can now typically work up till 74.2 of age, an increase of more than seven years from 67.1 in 1990.

For example, Mdm Pow Soh Liew, who turns 62 next month, cannot see herself stopping work at her age.

The production executive at Panasonic Appliances Refrigeration Devices Singapore said she would “not be able to take it” if she had to sit around at home for more than two days.

Mdm Pow, who has three grown-up children, said that if she were to leave her current employers, she would look for work in a supermarket to earn “pocket money” so that she can go on holidays.

Dr Danny Ker, 62, who graduated top of his class last month with a specialist diploma in advanced digital manufacturing at German Institute of Science and Technology – TUM Asia, also has no plans to stop working.

“Sixty-two is still an active working age in my case… 67 years old is also still too young to retire,” said the vice-president for quality management at TÜV SÜD PSB, a testing, inspection and certification service provider.

Adding that his father retired at the age of 85, he said that he would look to start his own business if the day comes that nobody is willing to hire him because of his age.

FIRMS AND WORKERS 'NEED TO BE OPEN WITH EACH OTHER'

Despite the negative experiences of some older workers, experts and observers believe that the re-employment and retirement ages are here to stay, and they serve as important safeguards — even though they are not foolproof.

Senior Minister of State Heng Chee How, who is the deputy secretary-general of NTUC, reiterated that without legislation, firms can unilaterally set lower retirement ages.

“For the foreseeable future, the view of the tripartite partners is that having a statutory retirement age remains a valid and significant safeguard,” said Mr Heng, stressing that there are avenues for older workers — whether they are union members or not — to lodge complaints against errant employers. 

Assoc Prof Theseira also stressed the need for retirement and re-employment laws.

And he believes that older workers need to adjust their expectations. “If wages and work responsibility are inflexible, this could lead to more unemployment among older workers,” he said.

He noted that it is unrealistic for workers in Singapore to expect wages to keep going up.

He sees re-employment as an opportunity for employers to reset the relationship between pay and work output. “It is just that we do not accept… that wages can go down,” he added.

CIMB Private Banking economist Song Seng Wun felt the key is for employers and older workers to have open communications, even if these entail uncomfortable discussions on changes to wages and job roles.

Such discussions could centre around the contributions that the older worker can continue making, with an eye perhaps on gradually scaling back his or her involvement with the firm.

Citing himself as an example, Mr Song, 59, said he would not mind taking a hefty pay cut if this comes up for discussion with his employers. “(For some people,) it’s not really a case of you needing the money, but something to do,” he said.

“It is not a right that because I ended up, at 60, with this amount of salary .. I am entitled to that forever and even more, just because I am still working,” he said.
Read more at https://www.todayonline.com/big-read/big-read-not-foolproof-re-employment-protects-older-workers-leaves-some-bitter-taste-their