Formulating a comprehensive elderly care policy to deal with population ageing  (2014/6/11)

President, an ageing population is a common phenomenon around the world. According to the projections of studies undertaken by the United Nations, by 2050, the number of world population aged 65 or above will be three times the current figure. Countries in Europe, America, Africa and Asia must all face the problems arising from a rapidly ageing population, and Hong Kong is no exception. In Hong Kong where filial piety is traditionally regarded as the most important virtue, it is the ideal pattern of ordinary families for different generations to live together, with elders in the family being supported and respected. Although times have changed with a more rapid tempo of life, children will strive to support their parents so long as they have the means because they want to repay their parents' love and care. Over the years, the Government has been promoting an elderly policy with "ageing in place as the core, institutional care as back-up". I strongly support this policy as ageing in place can help promote a harmonious family relationship, while the responsibility of caring for the elderly will not be shifted to society, thereby increasing the Government's burden.

Although the policy of "ageing in place as the core" can reduce the Government's burden, the expenditure of families will certainly increase. In order to encourage younger generations to live with the elders, the Government should consider providing more benefits to families with elderly members, such as increasing the dependent parent/grandparent allowance or providing rates waiver, so as to give additional incentive or reward to those middle-class people with the means to live with their elders.

Regarding single elderly persons or elderly couples without care and support, the Government should enhance community support services for them through the provision of additional day care centres for the elderly, as well as activity facilities and venues for the elderly in the community, so that elders can participate more in community activities in the neighbourhood. In many foreign countries, there is a long history of setting up dedicated communities for the elderly, so that they can live a comfortable retirement in a well-equipped environment. The Government should also give more consideration to the actual needs of elders in Hong Kong, and provide necessary supporting facilities in different communities. In that case, elders in good health can live in a familiar environment for as long as possible, and they do not have to live in residential care homes for the elderly (RCHEs) prematurely or needlessly. In fact, most elders generally prefer not to stay in RCHEs unless it is absolutely necessary to do so.

Notwithstanding, in view of an ageing population, the demand for RCHEs will just keep increasing. According to the data provided by the Social Welfare Department (SWD), at present, there are around 76 000 residential care places for the elderly in Hong Kong (including almost 26 000 subsidized ones), while some 23 000 elders are on the waiting list. On the other hand, there is a surplus of 10 000 residential care places in the private sector. It shows that social services have not been used properly. In the 2014-2015 financial year, the amount of subsidies provided by the Government for each place in contract homes is $13,629 per month, while the amount for each place in private homes participating in the Enhanced Bought Place Scheme (EBPS) is $9,506 per month. Given the vast difference between the Government's resource allocation and expenditure on RCHEs under its management and the subsidies provided to RCHEs participating in the EBPS, there is a certain gap between their standards in terms of both facilities and services. Hence, many elders residing in RCHEs participating in the EBPS are still waiting for allocation to government RCHEs. If no action is taken by the Government to optimize the use of the existing private RCHE resources, it would be very difficult to resolve the problem of an ever-increasing number of applicants on the waiting list no matter how much extra effort is made to construct RCHEs.

President, in order to address the elderly's lack of confidence on private RCHEs, the Government must have long-term planning and adopt a practical mechanism for improving the facilities and service standard of private RCHEs so that they can be on a par with subsidized RCHEs. Coupled with the provision of subsidies in the form of cash vouchers and the adoption of the "money-follows-the-user" approach, the utilization rate of private residential care places can be increased.

In order to enhance the elderly's confidence on private RCHEs, the Government can consider introducing a grading system on the performance of both public and private RCHEs, so that only RCHEs subject to the grading system would be eligible for accepting elders receiving government subsidies. In other words, eligible elders can either choose to wait for allocation to government RCHEs or use their cash vouchers to purchase the service of private RCHEs with the same standard. Regarding elders with financial support from family, they can choose to live in either public or private RCHEs with better facilities and enjoy a better quality of life by using their cash vouchers and paying the shortfall in fees on their own. The introduction of a grading system can help set a uniform service standard for RCHEs, enhance the quality of private RCHEs, increase the mobility of residential care places and address the public's general lack of confidence on private RCHEs. Under the grading system adopted in the United States, RCHEs all over the country would be graded by the Centers for Medicare & Medicaid Services on a quarterly basis, and no government subsidies would be provided to RCHEs which fail to comply with the required standard.

Adopting a grading system can help enhance the image of the elderly care services industry and attract new entrants to the field. Moreover, investors who operate the RCHEs can decide their scale of investment according to their own market positioning. As a result, the industry will develop towards a healthy direction.

President, I so submit.