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What I would like to do is to take the example of the hospice services in Singapore and see how they have evolved over the past few years, in order to look into the future for in-patient hospices.
Singapore currently has six voluntary welfare organisations which provide different hospice services. They comprise the five full members and one affiliate member of the hospice umbrella body, the Singapore Hospice Council. Together, these services served over 1,400 patients dying from cancer in 1995. This covers 40% of the 3,500 cancer deaths that we had in Singapore in that year.
There are three in-patient hospices: St Joseph's Home with 22 beds, Dover Park Hospice with 40 beds and Assisi Home and Hospice with 32 hospice beds and 7 long-stay tetraplegic beds. Of these, the first two organisations run in-patient services only. Assisi Home and Hospice started a hospice day care service in 1993 and a home care service in 1995. Two other charities in Singapore also run hospice home care services, the Singapore Cancer Society which was the first to do so, and the Hospice Care Association, which runs the largest home care service in the republic, serving some 1,380 patients in 1996. The affiliate member of the Singapore Hospice Council, the Methodist Hospice Fellowship, provides spiritual support to dying patients and does not run a full-fledged hospice service with medical and nursing input.
In Singapore, the development of hospice care was affected by our local history, where the concept of an in-patient hospice was associated with the "death houses" which used to exist in in Chinatown. These so-called death-houses were run by charitable Chinese clan associations to take care of the destitute coolies, amahs and indentured labourers who were dying away from their families in China. The houses were situated in a street of coffin-makers called Sago Lane. The dying had no medical care, just food and shelter, and horrific stories were told about how they might have to sleep in their coffins before they die.
When philanthropists in Singapore first wanted to build an in-patient hospice in 1975, the application was turned down by the government, which at that time was trying to rid Singapore of the scandal of the "death houses" by razing the whole street, Sago Lane, to the ground. Hospice became a dirty word in official circles, and it was not until 1985 that another attempt was made to provide hospice care for the dying.

 

 

 

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