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S
p eech
P
athology
A
ustralia
MULTICULTURALISM AND DYSPHAGIA
Health care system
In 2005, Singapore spent 3.7% of its gross domestic product
on health care (Ministry of Health, 2007). The philosophy
behind Singapore’s health care system is that good, affordable
health care will be made available to all Singaporeans through
subsidised medical services. At the same time, the health care
system encourages personal responsibility towards medical
expenses through a system of co-payment. Hence health care
expenses are paid for through a combination of taxes, medical
benefits, insurance, compulsory medical savings and out-of-
pocket payment. There are several schemes in place to help
Singaporeans “co-pay” their health care expenses. “Medisave”
is a national medical savings scheme which helps individuals
set aside a portion of their monthly
salary for future health care needs for
themselves or their family. A second
scheme, “Medishield”, is an optional
medical insurance scheme which can be
used to pay for prolonged illnesses and
larger hospital bills. Another scheme
called “Medifund” is a government
financial assistance scheme to help
patients from low-income groups. Needy
families can also apply for financial
assistance from charitable organisations.
Singapore’s health care system is
organised into three levels of care:
primary health care, hospital care, and intermediate and long-
term care. Primary health care refers to preventive health care
and health education. Private practitioners provide about 80%
of primary health care services while government polyclinics
provide the remaining 20%. Hospital care is covered by seven
public hospitals, as well as six specialty centres for cancer,
cardiac, eye, skin, neuroscience and dental care services.
Lastly, intermediate and long-term care needs are met by
community-based health care providers. Facilities available
include community hospitals, home nursing and home
therapy services, day rehabilitation centres, daycare centres,
and nursing homes. These facilities are funded by government
grants, public donations, private donors and/or religious
organisations. The community sector also provides a broad
range of programs for disability services. These range from
day activity centres where clients learn and practise basic self-
help skills, to apprenticeship and work placement programs.
Education system
Singaporean children typically begin the first year at primary
school at the age of six. The mainstream education program
consists of six years of primary school education and four or
five years of secondary school education. At the end of
secondary school, students sit for the Cambridge GCE “O”
Level examinations, which are conducted by examiners in the
United Kingdom. Subsequently, students wishing to pursue
tertiary education may enter a pre-university course (two
years) followed by a degree course at university, or a
polytechnic to obtain a diploma in their chosen field.
Keywords:
health care,
rehabilitation,
Singapore,
special education,
speech therapy
Overview of Singapore
Singapore is an island state, just south of
the Malay Peninsula. Singapore is one of
the 16 smallest countries in the world at 707.1 sq km. It is also
one of the most densely populated countries, with a
population of 4.59 million people. The country’s name is
derived from the Malay “Singa” and “Pura” which together
mean “Lion City”. According to legend, the island was a quiet
fishing village when a young prince visited from nearby
Sumatra. He mistook a majestic-looking animal for a lion and
gave the island its name.
Singapore was a British settlement in the 19th century. It
was an important trading port for ships plying between
Europe and East Asia. Singapore thrived as a trading port and
also as an export centre for rubber. Self-government was
attained in 1959 when the Singapore Constitution was signed
in London, releasing Singapore from British rule. Singapore
became an independent country in 1965 and continues to
blossom and develop diverse industries. Today, Singapore has
an established manufacturing industry, it is a leading financial
and business centre in Asia, and is growing as a vibrant
medical, education and research hub. Singapore has become
the world’s busiest port and a major player in the shipping
industry.
Singapore is a cosmopolitan country made up of people
from all over the world. The society is multicultural, multi-
religion and multilingual. There is an ethnic mix of Chinese
(75.0%), Malays (13.7%), Indians (8.7%), Eurasians and
smaller minority groups (2.6%). English is the main language
for administration and business, and other official languages
include Malay, Chinese, and Tamil (Ministry of Information,
Communication and the Arts, 2008).
S
peech
P
athology
in
the
A
sia
-P
acific
R
egion
Speech-language therapy in Singapore
Elizabeth Jane Teh and Melissa Hui Ling Chua
Singapore is a small city-state with a population of more
than 4.5 million people. The society is multicultural and
multilingual. The country has a comprehensive health
care system and education system. Speech-language
therapy (SLT) services started on a small scale in the
1960s. Today, a full spectrum of SLT services are offered
by a growing population of speech-language therapists
working in hospitals, schools, community settings and
private practice. As the demand for speech-language
therapy grows, the professional community faces
increasing challenges to meet the needs of the population
and to develop in new directions.
Elizabeth
Jane Teh
Melissa Hui
Ling Chua