Duty visit of joint-Panel to Guangdong-Hong Kong-Macao Bay Area (2018/4/20-2018/4/22)
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In June last year, the Government released the Elderly Services Programme Plan (“ESPP”) formulated by the Elderly Commission. In this connection, will the Government inform this Council:
(1) as ESPP has made it a primary strategy to achieve “ageing in place” and reduce institutionalization rate through significantly strengthening community care services (“CCS”), and put forward a number of recommendations in this respect (e.g. enhancing Integrated Home Care Service (“IHCS”) and reviewing the funding modes of IHCS and Enhanced Home and Community Care Service), of the follow-up actions taken by the Government on such recommendations (including the specific measures to be implemented);
(2) as ESPP has pointed out that in order to actualize the principles and strategic directions set out in ESPP, it is necessary to forge the partnership among the pivotal players in the interface between welfare, healthcare and housing, whether the Government will consider setting up an inter-departmental task force to coordinate the relevant work;
(3) as ESPP has put forward a number of recommendations to strengthen the financial sustainability of elderly services, how the Government follow up such recommendations; whether it has assessed the annual recurrent expenditure involved in implementing the recommendations set out in ESPP;
(4) as ESPP has come up with indicative planning ratios for the year 2026 of 21.4 subsidized residential care services places and 14.8 subsidized CCS places for every 1 000 elderly persons aged 65 or above, whether the Government will adopt such indicative planning ratios; if not, of the reasons for that; and
(5) of the progress of the work of the Government on the other recommendations set out in ESPP; whether the Government has drawn up an implementation timetable for the various recommendations?
My reply to the Member’s question is as follows:
(1) The Government’s elderly care policy is “Ageing in place as the core, institutional care as back-up”. The Government has all along been supporting elderly persons to age in place through various community care and support services. With reference to the strategic direction proposed by the Elderly Services Programme Plan (ESPP) of achieving “ageing in place” and reducing institutionalisation rate through a significant strengthening of community care services, the “2017 Policy Agenda” announced a series of new initiatives to enhance community care and support services. These initiatives include providing an additional 1 000 vouchers (bringing the total to 6 000) under the Second Phase of the Pilot Scheme on Community Care Service Voucher for the Elderly in 2018-19 to support ageing in place for elderly persons with moderate or severe impairment; enhancing dementia care and support at the community level; and enhancing outreaching services for supporting those needy carers living in the community who are looking after frail elderly persons.
In addition, the Government has secured funding from the Community Care Fund to implement pilot schemes to take forward two ESPP recommendations on strengthening support for elderly persons with mild impairment and strengthening support for elderly persons discharged from hospitals. The Government launched the Pilot Scheme on Home Care and Support for Elderly Persons with Mild Impairment in December 2017 to provide them with appropriate home care and support services. The pilot scheme is expected to provide around 4 000 service places within three years. The Government also launched the Pilot Scheme on Support for Elderly Persons Discharged from Public Hospitals After Treatment in February 2018 to provide elderly persons in need of transitional care and support with suitable services, including transitional residential care and/or community care and support services. It is expected that the pilot scheme will provide support for at least 3 200 elderly persons within three years.
On the other hand, with reference to the relevant recommendation of the ESPP, the Social Welfare Department (SWD) is reviewing the catchment areas and funding modes of the Integrated Home Care Services (Frail Cases) and Enhanced Home and Community Care Services, and will make recommendations on the future direction of these two services and initiate discussions with social welfare organisations.
(2) As set out in the ESPP, since population ageing touches on a wide array of complex and multi-faceted issues, it is necessary to promote and facilitate effective interfacing and collaboration amongst diverse sectors, organisations and stakeholders to achieve the principles and strategic
directions of the ESPP. The Government is committed to forging more effective partnership among welfare, healthcare and housing sectors through various channels and platforms. The Government launched the Dementia Community Support Scheme in February 2017 to provide cross-sectoral and multi-disciplinary support services for patients with mild or moderate dementia and their carers at
the community level through a medical-social collaboration model. Separately, SWD has all along been communicating and co-ordinating with the relevant Government departments (including Planning Department (PlanD), Lands Department, Housing Department, etc.) to reserve sites for the provision of more elderly services facilities. For instance, SWD has reserved sites in 30 development projects for the construction of new contract homes and day care centres/units for the elderly.
The Elderly Commission will continue to serve as a platform facilitating coordination among bureaux, departments and organisations concerned, and regularly review the progress of the relevant policies.
(3) The ESPP proposed that a more forward looking approach should be adopted in public expenditure on elderly services in response to the changing socio-economic profile of the elderly population and in promoting a more equitable sharing of financing long-term care (LTC) in
the current population and across generations. The ESPP suggested the Government to consider co-payment for services commensurate with affordability, exploring measures to facilitate non-governmental organisations to provide self-financing services and exploring alternative
LTC financing options.
On the other hand, in the 2017-18 Budget, the Financial Secretary has earmarked $30 billion to strengthen elderly services and rehabilitation services for persons with disabilities. The Government has allocated around $2.9 billion out of the earmarked provision for implementing initiatives to strengthen elderly services and rehabilitation services. These initiatives include taking forward a series of measures to strengthen the monitoring of residential care homes for the elderly and enhance their service quality; organising territory-wide public education activities to enhance public understanding of dementia; setting up the $1 billion Innovation and Technology Fund for Application in Elderly and Rehabilitation Care to subsidise elderly and rehabilitation service units to try out and procure/rent technology products; and providing speech therapy services for elderly service units. The Government will, having regard to the practical circumstances and needs, further strengthen elderly services with the earmarked funding of $30 billion.
(4) The ESPP recommended the reinstatement of population-based planning ratios in the Hong Kong Planning Standards and Guidelines (HKPSG) to allow better forward planning of the relevant department(s) in reserving sites and premises.
According to the projections in the ESPP, the indicative planning ratios for subsidised long term care services in 2026 are 21.4 subsidised residential care places and 14.8 subsidised community care places per 1 000 elderly persons aged 65 or above. In addition, the ESPP recommended that there should be one District Elderly Community Centre in each new residential area with a population reaching 170 000. Where appropriate, there should be one Neighbourhood Elderly Centre in each new and redeveloped public rental housing estate and one in private housing areas with a population of 15 000 to 20 000 in new residential areas. To follow up on the recommendations concerned, the “2017 Policy Agenda” sets out that the Government plans to reinstate the population-based planning ratios for elderly services in the HKPSG. The Labour and Welfare Bureau and SWD have commenced discussions with the Development Bureau and PlanD in this regard, including the drawing up of specific amendments to the HKPSG. After the HKPSG has been amended, we will review and update the relevant planning ratios at suitable junctures, to ensure that the planning of facilities could meet the service demand.
(5) Four strategic directions and 20 short, medium to long term recommendations on the future development of elderly services were made in the ESPP. Among them, the follow-up of the short term recommendations will commence within two years after the completion of the ESPP, while that of the medium to long term recommendations will generally commence within three to five years following the completion. The Government has accepted in principle the strategic directions and recommendations in the ESPP, and has commenced the follow-up actions, to make arrangements for the implementation of the recommendations.