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Chief Secretary Carrie Lam
With the ever-growing elderly population, the Government strives to implement a series of measures to strengthen elderly services on all fronts. The resources committed by the Government to elderly care welfare services have continued to increase in the past years. The relevant recurrent government expenditure has increased from around $3.9 billion in 2010-11 to about $6.8 billion in 2015-16, representing an increase of 73.6%.
In line with the policy of promoting "ageing in place as the core, institutional care as back-up", the Government has been making strenuous effort in strengthening the provision of various types of subsidised community care and support services. For home care services, all of the 1,666 additional Enhanced Home & Community Care Services places will have commenced service in June 2015. At the same time, the service content of all Enhanced Home & Community Care Services places has been strengthened. In addition, the Social Welfare Department is implementing the Pilot Scheme on Community Care Service Voucher for the Elderly, which adopts a "money-following-the-user" approach. The Social Welfare Department will take into account the findings of the mid-term review of the Pilot Scheme and work out the details of the next phase.
The funding allocation for subsidised community care and support services in 2015-16 is estimated to reach $2.33 billion, representing an increase of around 14.5% over the provision for last year. From 2015-16 to 2016-17, it is estimated that some 100 new day care places could commence service. The Social Welfare Department has also earmarked sites in eight development projects for the construction of day care centres/units for the elderly, providing an estimated total of 370 additional day care places. In addition, the Social Welfare Department will make flexible use of day care places to serve elderly persons living in districts with longer waiting time through cross-district arrangement.
For elderly persons who are not suitable for ageing at home owing to their health conditions or other reasons, the Government will continue to increase the provision of residential care places through a multi-pronged approach. In 2015-16, resources committed by the Government to providing subsidised residential care services will reach $4.26 billion, representing an increase of some 8.4% over the provision for last year. Around 1,710 additional subsidised residential care places for the elderly will be put to operational use between 2014-15 and 2017-18. Social Welfare Department has also earmarked sites in 11 development projects for the construction of new residential care homes for the elderly to provide about 1,200 new residential care places for the elderly. In addition, the Government has commissioned the Elderly Commission to conduct a feasibility study of the voucher scheme on residential care services for the elderly adopting the "money-following-the-user" approach with a view to better utilising the residential care places at non-subsidised residential care homes for the elderly and providing incentives for these residential care homes for the elderly to improve their service quality. In this regard, the Government has earmarked about $800 million to issue a total of 3,000 residential care service vouchers by phases over three years from 2015-16 to 2017-18. In the meantime, the Government will continue to identify suitable sites for constructing more contract residential care homes for the elderly.
For the medium to long term, the Government injected $10 billion into the Lotteries Fund in early 2014 to facilitate the implementation of the Special Scheme on Privately Owned Sites for Welfare Uses by the Labour & Welfare Bureau. It aims to better utilise the sites granted to non-governmental organisations through expansion and redevelopment, with a view to providing more residential care places and day care places for the elderly as well as rehabilitation facilities which are in great demand. The Scheme has received positive responses from over 40 organisations, involving more than 60 projects. If all these projects could be implemented as proposed by the organisations, as many as 17,000 additional service places would be provided for the elderly and persons with disabilities, including around 7,000 residential care places and 2,000 day care places for the elderly.
The Government agrees that effective measures should be taken to improve the service matching and allocation mechanism for subsidised elderly care services. The Social Welfare Department has commissioned a consultancy study to update the assessment tool of the Standardised Care Need Assessment Mechanism for Elderly Services. The updating process is expected to be completed by 2016. This will help the Social Welfare Department suitably allocate long-term care services in accordance with the need and urgency of the elderly applicants.
The Government agrees that there is a need to expedite the long-term care services planning for the elderly in the face of the immense challenges posed by our rapidly ageing population. As announced by the Chief Executive in his 2014 Policy Address, the Elderly Commission is tasked with the formulation of the Elderly Services Programme Plan. The Elderly Commission is now actively taking forward the task, including the organisation of public engagement activities, and is expected to submit its report to the Government in mid-2016.
Health services
On the provision of health services for the elderly, the Government generally welcomes and accepts the recommendations made by the Audit Commission (Audit) and the Public Accounts Committee of the LegCo on the health services for the elderly provided by the Department of Health and the Hospital Authority.
Adopting the family medicine approach which emphasises holistic care, continuity, teamwork and multi-disciplinary input, Elderly Health Centres provide comprehensive primary health care to the elderly. The Government notes members' concerns over the long waiting time for first-time health assessments, and will review and monitor the workload of each Elderly Health Centres with a view to implementing measures to enhance service efficiency and shorten waiting time.
The Public Accounts Committee recommends the Department of Health conduct a comprehensive review of Elderly Health Centres' mode of operation to better cope with the growth in service demand arising from an ageing population. The Department of Health has been reviewing the service capacity and mode of operation of Elderly Health Centres from time to time, and will follow up the Audit's recommendation for improvement. Nevertheless, the service of Elderly Health Centres alone would not be able to fully meet the challenges of growing demand for elderly healthcare services arising from the ageing population. Therefore, the Government should adopt a multi-pronged approach to provide primary healthcare service for the elderly by implementing different initiatives and service models. To this end, we have mapped out a long-term primary care development strategy and implemented a number of measures and pilot projects on different primary care delivery models for elderly health services in the past few years, such as the Elderly Health Care Voucher Scheme and the Elderly Health Assessment Pilot Programme. The Department of Health will review the Elderly Health Centres' capacity and strategic directions in the light of the experience gained through these new models of service provision. A comprehensive review of the Elderly Health Care Voucher Scheme will be conducted in mid-2015 and an evaluation of the implementation of the Elderly Health Assessment Pilot Programme will be completed by end-2015/early 2016.
Meanwhile, the Department of Health will continue to promote these programmes to the elderly and explore different ways to encourage participation of healthcare service providers in the Elderly Health Care Voucher Scheme as well as strengthen monitoring measures to ensure proper use of public fund.
The Hospital Authority is committed to providing quality health services to the public (including the elderly). We understand the public's concerns over the waiting time at the specialist outpatient clinics. Hospital Authority has already implemented further measures to improve the relevant services. These measures include:
(a) enhancing public primary care service;
(b) strengthening manpower;
(c) implementing public-private partnership;
(d) enhancing transparency by uploading the waiting time information of all eight major specialties to the Hospital Authority 's website;
(e) implementing arrangement to facilitate cross-cluster appointment booking for consultation; and,
(f) improving the appointment scheduling arrangement.
Moreover, the Hospital Authority has in recent years extended the Community Geriatric Assessment Service, now covering around 89% residential care homes for the elderly in the territory. The Hospital Authority will continue to review the service model and provision of Community Geriatric Assessment Service and consider providing the service to more residential care homes for the elderly as appropriate.
New aviation HQ
The Government attaches great importance to the observations and recommendations set out in the reports of the Audit and the Public Accounts Committee regarding the new Civil Aviation Department headquarters project. The Civil Aviation Department and the Architectural Services Department have implemented various measures to enhance internal control and alerted their staff to the experience and lessons learnt from the audit findings.
The objective of developing a new Civil Aviation Department headquarters is to bring all operational divisions of the Civil Aviation Department under one roof and to house the new air traffic control system. The project aims to enhance the Department's overall operational efficiency and capability in handling air traffic management, so as to cope with the continued growth of air traffic volume and further strengthen Hong Kong's status as an international and regional aviation hub.
Although the new headquarters project largely meets the needs of Civil Aviation Department and it was completed within the contract period and within budget, there were indeed areas not properly handled by Civil Aviation Department during implementation of the project. We are particularly concerned about the deviations from the Government's internal procedures and requirements during the implementation of the project as pointed out in the Audit Report. As such, the Transport & Housing Bureau is examining the report submitted by the Director-General of Civil Aviation. If any misconduct is found, the Government will follow up the case in accordance with the established procedures, including taking appropriate administrative or disciplinary action. As for Public Accounts Committee's wish to know the contents of the report and the follow-up actions to be taken by the Transport & Housing Bureau, as mentioned in the speech of the Chairman of Public Accounts Committee, the Government will actively respond to such request.
To ensure proper use of public funds, the Government has established mechanisms to govern implementation of capital works projects including the requirement to seek approval for the schedule of accommodation and procurement of furniture and equipment items. The said mechanisms are detailed in the government internal guidelines and circulars for the compliance by and reference of all government departments.
The Government will continue to strive to submit accurate information to the LegCo to facilitate Members' consideration of government funding proposals. The Government has promulgated internal circular setting out issues which government departments need to pay attention to when preparing relevant submissions to the panels, Public Works Subcommittee and Finance Committee of LegCo. The first and foremost principle is that full and accurate information should be provided to LegCo. With regard to the recommendations of the Audit and Public Accounts Committee, the Transport & Housing Bureau has promulgated a circular to departments under its purview, requesting them to regularly remind subject officers of the need to provide up-to-date information when preparing LegCo submissions. The Civil Aviation Department has also updated the departmental handbook and informed staff of the need to submit full information to LegCo.
This is a translation of the speech given by Chief Secretary Carrie Lam in the Legislative Council on May 20.
