A conversation with David Ong, Partner in Corporate & Financial Services in Chooi & Company Advocates & Solicitors, discussing Malaysia’s aged care and the legal framework supporting it.
Is Malaysia truly prepared for ageing? As Malaysians live longer, are there enough safety nets to ensure we can live better in our old age? As retirement, senior living and aged care require a holistic and multi-disciplinary approach to set up properly and sustainably, it is important to understand that it is above and beyond any one part of our society to handle. A major factor Malaysians should be aware of is how an aged care ecosystem should work, what needs to be set in place and how Malaysia’s legal framework can support the infrastructure. It could make or break us.
Having been named a Recommended Individual by Asialaw Profiles in the Guide to Asia-Pacific’s Leading Domestic Law Firms 2015, with a keen interest and wide experience in advising a wide range of infrastructure projects, David Ong shared his thoughts on the aged care ecosystem:
“If we want to grow old with dignity, the entire ecosystem must facilitate a regulatory standard for elderly care and its’ enforcement.”
Challenges in Current Acts
To explanation on the issues mentioned, here is a brief look into the current challenges in Malaysia’s aged care:
1. No Act to regulate standards of care for the elderly
• Currently, the only two Acts that serve any form of regulations for care providers is the Care Centre Act and the Private Healthcare Facilities & Services Act.
• The Care Centre Act generally applies from child care to rehabilitative care centres and even old folks home.
• On the other hand, the Private Healthcare Facilities & Services Act specifically covers the standards of healthcare services that are administered by professionals such as private hospitals and medical diagnostic centres.
2. No Enforcement
• Some care centres do not even register themselves under the Care Centre Act.
• Quality of care varies and is arbitrarily dependent on the care provider’s conscientiousness.
• The safety aspects are often ignored, such as the basic requirement to have fire escapes.
Ong stated these challenges are where the legal framework comes in to set the standard that is appropriate for elderly care. Essentially, a regulatory standard that oversees care for the elderly requires care providers to give a level of care that is higher than what the Care Centre Act provides, but not at the high levels of a medical facility such as hospitals.
“Ultimately, the purpose of these aged care facilities is to provide a living standard for the elderly. So first of all what do you promise them? It’s about setting up a program, establishing what you can deliver, documenting it and selling that. It’s about product disclosure, being truthful about what you are selling and making sure you can deliver” said Ong.
Hence, the new Private Aged Healthcare Act is eagerly awaited on to see how it will specifically address the needs of the elderly and elevate the standards of the industry.
The Elder Abuse Dilemma
According to Ong, elder abuse is a relatively new form of violence that is currently being addressed in the Malaysian consciousness. Abuse – be it financially, physically or psychologically – directly impacts the quality of life of our elderly and is an issue which must be managed.
However, the difficulty comes in twofold:
• The abuse is often perpetrated by immediate family members behind closed doors and is difficult to address.
While cases of stealing money or physical violence are obvious, cases whereby a person is taken advantage of, such as being treated as a domestic helper or just being neglected are much less easily identified.
• Malaysia has no law to specifically address the importance of elderly welfare.
Our neighbour countries, like Vietnam or Thailand that has laws on elderly persons – which guarantees the elderly rights to basic necessities by the government.
Australia and UK’s anti-discrimination Act makes discrimination on the basis of age for employment, provisions of goods and services, accommodation and etc.
Despite Malaysia’s National Health Policy for Older Persons and Plan of Action for Older Persons (revised in 2011), there is no definitive lead driver for it.
“The Ministry of Women, Family, and Community Development should take the lead to drive it, but ultimately industry players need to work together as the Ministry cannot work alone. The Ministry of Health needs to put in their thoughts and private sectors need to contribute” said Ong.
The Financially Challenged
When it comes to retirement and aged care, money is often the key concern. As evident by the many reports from the Employee Provident Fund (EPF), Malaysians are not saving enough. Therefore, all segments of the ecosystem need to educate and echo the message on awareness to start saving earlier.
To communicate this message, incentives need to be created and integrated into the ecosystem to get it running. Some suggested incentives include:
• Giving tax incentives for putting money aside for parents’ retirement, encouraging competition among insurance companies.
• Fund managers to drive costs down for ageing needs, and private sectors developing more innovative structuring of products and prepayment of future care are good starting points.
However, some may perceive setting aside money for retirement as a luxury for people who can afford it. For many who are in the lower income thresholds, merely supporting their daily needs is a struggle.
In addressing this issue, Ong cited cases of what foreign countries have done as a reference for Malaysia could possibly look into;
• Singapore’s Maintenance of Parents Act – which allows parents to claim maintenance from their children
• Singapore’s Medical and Elderly Care Endowment Act, Thailand’s Older Persons Fund and Australia’s Aged Care Act – each act provides some form of financial support for the provision of aged care for those who need it as a common denominator.
The Malaysian Government has helped by raising the minimum wage and retirement ages, but more needs to be done.
“Creating indirect measures such as introducing pension cards for free public transportation or subsidies for medical supplies will also help. Additionally, volunteerism at government-sponsored day care centres for the elderly will also create a greater sense of support.” said Ong.
What Can The Relevant Parties And The Public Do?
If the role of the State is to provide the grease – setting policies, standards and introducing incentives, the private sector are the cogs and wheels of the ecosystem.
The private sector plays the key role in advancing the aged care ecosystem as they will provide the bulk of the care services, design and build retirement homes, and create products & services to enhance elderly living. It is therefore, imperative that strong partnerships be established between Public and Private sectors.
“We need more Public & Private Partnership initiatives to create more low cost retirement villages and other forms of support for the aged care industry through grants and subsidies.”
In conclusion, Ong stated that the set-up for the aged care ecosystem and the legal framework to support it comes down to all parties – family members, operators, the State and enforcement agencies – acknowledging that looking after our elderly and ensuring they lead a dignified life is a collective responsibility and only by working together can results be achieved.
“Enforcement is not a box-ticking exercise, checking if you have done this and that and saying if you are breaching the law or not. If people are not respecting the law, they will break it anyway. So it comes down to our society’s values where people need to have greater respect for the law.” said Ong.
Aged Care Group (ACG) is an organisation engaged in the business of elevating and providing aged care services in Malaysia. ACG is driven with a strong vision to advocate innovation and transformation in ageing by offering continuum care as a premium choice for enriched living. We operate in an ecosystem that provides integrated care services and products through meaningful partnerships with individuals, government, organisations and corporations. ACG seeks to be the forerunner in all things related to aged care, building on the years of knowledge and experience of its shared holders and management team. A detailed profile of who we are can be obtained at www.agedcare.com.my.