ACQ Vol 11 No 1 2009

MULTICULTURALISM AND DYSPHAGIA

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

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

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.

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:

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

Elizabeth Jane Teh

Melissa Hui Ling Chua

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.

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 p eech P athology A ustralia

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