On 16 January 2001, Ms Goh Soon Noi, Manager of Medical Social Services, Changi General Hospital, received the Outstanding Social Worker Award from the President of Singapore at the Istana. But the award means much more than personal recognition for Ms Goh. As an Ambassador for Medical Social Services, the award is a way of raising the professional standing for all medical social workers and generating greater awareness for the profession.

She has more than 20 years of experience working in many hospitals including Ang Mo Kio Community Hospital, NUH, AH, St Andrew's Community Hospital and Woodbridge Hospital. Now, she and her team of 8 social workers and three administrative assistants help people who pass through the 801-bed Changi General Hospital. She serves a diverse clientele, from elderly patients, patients suffering from cancer, failed suicide attempts, mental illness and spousal abuse victims.

Relating a case she handled years ago which left a deep impact on her, that there is a crucial need for care providers to be flexible and accessible, she recalled how she was called see an elderly woman soiled with faeces and wet with urine. At the home visit, she taught the woman's son how to clean her and how to care for her.

However, the woman's neighbours and home nurse wanted Ms Goh to move the elderly woman into a nursing home or a hospital. Due to a lack of support from them, the elderly woman was eventually institutionalised.

"Up to this day, I still feel her institutionalisation could be prevented if the support from the neighbours and home nurse was there," Ms Goh said, adding that in the next lap, "Care providers need to ensure that their services reach the very clients they are intended to serve and to respond flexibly and individualise the services if need be."

One of the key problems in caring for the elderly that is constantly on Ms Goh's mind is the integra-tion of services from hospitals to step down facilities. Having worked in government, restructured and voluntary hospitals, and different voluntary welfare organisations as staff, lay volunteer, management committee member and chairperson, she appreciates the issues that make integration of these services difficult.

With this in mind, she advocates for Integrated Care Services, mooted by medical social workers, to embrace the coordination of Home placement along with case management of difficult-to-place patients and new collaboration initiatives between hospitals and step down facilities.

As for the $5,000 training grant sponsored by ESSO Singapore Pte Ltd, Ms Goh hopes that it will partially defray the residential course offered by Harvard Business School under its Social Enterprise programme on Strategic Perspective in Non-Profit Management. The course will offer a new collaboration paradigm among the organisations across the different sectors - public, private and voluntary - involved in the care for the elderly.

"It is a real challenge to see an integration of services for the elderly - real integration at both strategic and operational levels", she said.