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Secretary for Labour & Welfare Matthew Cheung
Elderly care tops the policy agenda of the current-term Hong Kong SAR Government, and justifiably so, as our population is fast ageing. One in seven Hong Kong citizens is aged 65 or above. This figure will soar to a staggering one in three, or 2.56 million, by 2041.The challenge before us is how best to provide a full range of reliable, affordable and accessible elderly care services to meet growing demand in the next three decades.
The Government's recurrent expenditure on elderly care services in 2014-15 is estimated at $6.2 billion, representing about 11% of the total recurrent social welfare expenditure, and up by 15.1% over last year ($5.4 billion).
If one adds spending on social security payments and health care to elderly care services, recurrent expenditure for the elderly as a whole amounts to a substantial $56.3 billion or 18.3% of the total government recurrent spending. These figures speak volumes about our commitment to safeguarding and enhancing the well-being of our senior citizens.
Ageing in place
For obvious reasons, most people prefer to age at home in their community. We realise that adequate provision of community care and support services is the key to achieve this. This explains why our elderly care policy is premised on the philosophy of "Ageing in place as the core, institutional care as backup".
I see community care as the upstream and institutional care downstream. With institutional care being the final resort for the frail and less self-reliant, it follows that we need to strengthen community and home care service for the elderly as a matter of priority.
To face this challenge, the Labour & Welfare Bureau together with the Social Welfare Department are looking for creative and viable solutions. We need to think outside the box and be prepared to experiment with innovative ideas and break new ground.
Active ageing promoted
In recent years, the Government has redoubled its efforts to improve the quality of life of the elderly population, build an elderly-friendly environment and promote active and healthy ageing.
Let me cite a few examples. Since 2012-13, we have allocated $900 million under the Lotteries Fund to enhance in phases the physical setting, facilities and hardware of over 230 elderly centres throughout the territory.
We plan to allocate an additional recurrent provision of $160 million to all subvented elderly centres to further enhance the support for the elderly. Support services for elderly with dementia and their carers will also be strengthened.
Under the cardinal principle of ageing in place, we provide our senior citizens with diversified choices through a range of flexible modes of subsidy and service delivery.
Last year, we launched the Pilot Scheme on Community Care Service Voucher for the Elderly so that they may choose community care services that suit their own needs. Under the scheme, the user gets a voucher to the value of $6,000 per month for buying such service as home care, physiotherapy and daycare service.
Enhanced service quality
This user-oriented or "money follows users" approach seeks to enliven the market and enhance the quality of service in the long run. Arising from this pilot scheme, we consider it opportune to explore the feasibility of introducing a residential care service voucher scheme for the elderly and the Elderly Commission has been tasked to follow this up.
Meanwhile, the Government has earmarked $800 million for issuing a total of 3,000 vouchers in phases from 2015-16 to 2017-18.
To promote active ageing and encourage the elderly population to be socially mobile, better integrate into the community and widen their social network, we rolled out the Public Transport Fare Concession Scheme, commonly known as the "$2 Fare Scheme", last year.
The scheme enables eligible seniors and persons with disabilities to travel on most public transport at a concessionary flat fare of $2 per trip. It has proved overwhelmingly popular. The number of average daily trips under the scheme amounts to about 700,000. Of these, some 620,000 trips are made by the elderly. We aim to extend the Scheme to over 3,000 green fixed-route minibuses by phases starting early next year.
Mobile ‘fruit money’
We understand that some elderly citizens who have their family ties on the Mainland, particularly in Guangdong, may wish to retire there. As Guangdong is the preferred choice for most of these elderly, we launched the Guangdong Scheme last year so that eligible elderly can receive the Old Age Allowance, widely called the "fruit money", without having to return to Hong Kong to satisfy the local residence requirement. Over 16,000 people have benefited from the scheme so far.
Apart from welfare benefits, we have taken the innovative step of making our subvented residential care services "portable" to the Mainland. We will shortly launch a pilot scheme to purchase places from an elderly home in Yantian in Shenzhen, just across the boundary and run by a Hong Kong non-governmental organisation.
Similar arrangements will also be made with another home in Zhaoqing. We believe that this will provide an additional option for those who are on our waiting list for subsidised residential care places in Hong Kong.
Places boost
To boost significantly the provision of residential and day-care places for the elderly in the medium to long term, the Labour & Welfare Bureau has rolled out the creative Special Scheme on Privately Owned Sites for Welfare Uses last September.
The scheme aims to optimise the use of land and utilise the Lotteries Fund - for meeting the construction and other capital costs - in a flexible manner. Specifically, social welfare organisations are encouraged to better use their land through in-situ expansion or redevelopment, especially to provide additional facilities for elderly and rehabilitation services.
The scheme has drawn an overwhelming response. Through the scheme, we hope to provide over 9,000 additional elderly service places in the next five to 10 years. Of these, about 7,000 will be residential care service places, equivalent to about 25% of the current provision, and about 2,000 daycare places. These additional places will go a long way towards cutting the long waiting time for such places.
To underline our commitment to make this scheme a success, the Government has injected a substantial $10 billion into the Lotteries Fund to ensure the smooth implementation of this major social welfare infrastructure programme.
Holistic approach
We will forge ahead in increasing the supply of elderly service places on all fronts to address the ever rising demand. Hardware apart, we also need to address the human software issue, that is manpower supply from front-line care workers to physiotherapists and nurses.
It is important to note that to provide a firm basis for strategic and holistic planning in the medium to long term, the Elderly Commission has been tasked to prepare an Elderly Programme Plan within the next two years.
I have given a pen picture of our broad policy strategy and thinking on elderly care from the welfare angle. But this represents only one side of the coin. Of equal importance, of course, are healthcare and medical services.
To embrace the challenge of a fast ageing community, a cross-sectoral and multi-disciplinary approach is a must. To this end, the Labour & Welfare Bureau together with the Social Welfare Department will continue to join hands with the Food & Health Bureau, the Hospital Authority and the Department of Health as well as various non-governmental organisations and the academic sector to build synergy and collaboration.
I believe that given our concerted efforts, we will make Hong Kong a caring and friendly place for our senior citizens to live in and enjoy their golden years.
Secretary for Labour & Welfare Matthew Cheung gave these remarks at the Annual Scientific Meeting 2014 organised by the Federation of Medical Societies of Hong Kong.
