LCQ18: Care services for the elderly
25.8.2021

Following is a question by the Hon Chan Hak-kan and a written reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (August 25): Question: Regarding care services for the elderly, will the Government inform this Council: (1) in respect of home-based community care services (CCS) for the elderly, of the respective (a) numbers of places, (b) numbers of people waiting and (c) average waiting time for the (i) Integrated Home Care Services (IHCS) (Frail Cases), (ii) IHCS (Ordinary Cases) and (iii) Enhanced Home and Community Care Services, in each of the past five years (set out in a table); (2) in respect of centre-based CCS for the elderly, of the (i) number of places, (ii) number of people waiting and (iii) average waiting time for the day respite services provided by day care centres/units for the elderly in each of the past five years (set out in a table); (3) of the respective (a) numbers of places, (b) numbers of people waiting and (c) average waiting time for (i) day care service and (ii) home care service provided under the Pilot Scheme on Community Care Service Voucher for the Elderly in each of the past five years; (4) how the Government currently gauges the cost effectiveness of the services mentioned in (1) to (3); of the respective percentages of the current numbers of places of such services in the elderly population in Hong Kong in need of such services; (5) of the latest progress, since the Finance Committee of this Council approved the relevant funding in June last year, of the Government's work on purchasing properties for operating day care centres for the elderly and neighbourhood elderly centres; (6) of the (i) number of places, (ii) number of applicants and (iii) shortfall of places of subsidised residential care services for the elderly in each of the past five years, with a tabulated breakdown by (a) type of homes (i.e. homes for the aged, care and attention homes for the elderly, as well as nursing homes) and (b) type of places (i.e. subsidised places and those under the Enhanced Bought Place Scheme); (7) of the annual numbers of voucher users under the Pilot Scheme on Residential Care Service Voucher for the Elderly since its introduction in March 2017; (8) of the progress in the vetting and approval of the applications made, under the Special Scheme on Privately Owned Sites for Welfare Uses, by non-governmental organisations for providing additional services for the elderly on the lands owned by such organisations; (9) of the progress of implementing the recommendations put forward by the Elderly Commission in the Elderly Services Programme Plan published in mid-2017; and (10) given that the Government's policy objective is to promote "ageing in place as the core, institutional care as back-up", but the current expenditure on CCS for the elderly accounts for only 38 per cent of the total public expenditure on elderly services, whether it will reform the current system, so as to put more emphasis on implementing CCS? Reply: Regarding the question raised by the Hon Chan Hak-kan, my reply is as follows: (1) Those frail elderly persons, who are assessed as in need of community care services or residential care services by the Standardised Care Need Assessment Mechanism for Elderly Services, can apply for Integrated Home Care Services (Frail Cases) (IHCS(FC)) or Enhanced Home and Community Care Services (EHCCS); while other elderly persons can apply for Integrated Home Care Services (Ordinary Cases) (IHCS(OC)). For IHCS(FC) and EHCCS, the number of service places, the number of persons waitlisted and the average waiting time in the past five years are as follows: Financial year Number of service places Number of persons waitlisted (Note) Average waiting time (months) 2016-17 8 365 4 504 11 2017-18 5 819 15 2018-19 7 930 18 2019-20 10 365 5 595 12 2020-21 11 865 4 243 9 2021-22 (as at July 2021) 13 365 4 085 5 Note: Not including elderly persons classified as inactive cases because of their participation in the Pilot Scheme on Community Care Service Voucher for the Elderly. For IHCS(OC), the number of service users and the number of persons waitlisted in the past five years are as follows: Financial year Number of service users Number of persons waitlisted 2016-17 25 359 3 998 2017-18 25 079 4 323 2018-19 24 352 3 261 2019-20 23 390 3 614 2020-21 22 608 4 287 The waiting list for IHCS(OC) is kept and managed by non-governmental organisations (NGOs) providing the services. The Social Welfare Department (SWD) does not have information on the average waiting time for IHCS(OC). (2) For designated day respite services provided by Day Care Centres/Units for the Elderly (DEs/DCUs), the number of service places in the past five years is as follows: Financial year Number of service places 2016-17 No record 2017-18 170 2018-19 172 2019-20 189 2020-21 208 In addition, all subvented DEs/DCUs can make use of the casual vacancy in their service place to provide respite service for elderly persons and families in need. The SWD does not have statistics on the number of elderly persons waitlisted and the average waiting time for respite services. (3) For the Pilot Scheme on Community Care Service Voucher for the Elderly, the number of service places in the past five years is as follows: Financial year Number of service places Day care services Home care services Second Phase 2016-17 2 081 2 944 2017-18 2 254 3 040 2018-19 2 815 4 861 2019-20 3 210 6 806 2020-21 (April-September 2020) 3 250 7 123 Third Phase 2020-21 (from October 2020) 3 869 10 580 The SWD does not have statistics on the number of persons waitlisted and the average waiting time for individual recognised service providers. (4) Enhancing elderly services is a priority for the current-term Government. The total expenditure on elderly services in 2021-22 is estimated to reach $14.2 billion, which is around 89 per cent higher than the actual expenditure in 2017-18. The increase in resources allows the Government to provide more subsidised elderly services, hence reducing the waiting time for services by elderly persons in need. Since December 2018, the Government has instated population-based planning ratios for subsidised community care services for the elderly, residential care services for the elderly, District Elderly Community Centres and Neighbourhood Elderly Centres (NECs) in the Hong Kong Planning Standards and Guidelines. The Government will plan new elderly services facilities in accordance with the above planning ratios, and the demand and supply of various types of services in each district. (5) On June 30, 2020, the Finance Committee of the Legislative Council approved an allocation for the Government to purchase premises for the provision of welfare facilities, including DEs and NECs, etc. The SWD has completed consultation with the 18 District Councils and has openly invited submission of sale proposals. The SWD is now actively implementing the purchase scheme with relevant government departments. As the purchase scheme is still in progress, it is inappropriate at this stage to disclose specific information to avoid jeopardising negotiations with sellers. The Government will make announcement on the progress of the purchase when appropriate. (6) The number of subsidised places for different types of Residential Care Homes for the Elderly (RCHEs) in the past five years is as follows: Financial year Number of service places Subvented homes operated by NGOs and self-financing homes (Note 1) Private RCHEs participating in Enhanced Bought Place Scheme (Note 2) Contract homes (Note 3) Total 2016-17 16 899 8 087 2 150 27 136 2017-18 17 027 8 009 2 324 27 360 2018-19 17 076 7 991 2 390 27 457 2019-20 17 123 8 616 2 616 28 355 2020-21 17 150 9 315 2 690 29 155 Note 1: Including homes for the aged places, care-and-attention (C&A) places, C&A places providing a continuum of care (CoC), nursing home (NH) places and places purchased under the Nursing Home Place Purchase Scheme. Note 2: Not including the designed residential respite places provided by the homes. Note 3: Including C&A places providing a CoC and NH places. The number of elderly persons waitlisted and allocated with subsidised residential care places are as follows: Number of elderly persons 2016-17 2017-18 2018-19 2019-20 2020-21 Waitlisted for subsidised residential care places 35 931 37 911 40 778 39 655 36 789 Allocated with subsidised residential care places 5 607 5 219 5 366 5 487 5 418 (7) The SWD launched the Pilot Scheme on Residential Care Service Voucher (RCSV) for the Elderly in March 2017. The number of applicants and the number of persons issued with RCSV are as follows: Year (as at end-December each year) Number of applicants for RCSVs Number of persons issued with RCSVs 2017 967 290 2018 1 673 685 2019 2 034 971 2020 1 473 939 Total 6 147 2 885 (8) Six projects under the Special Scheme on Privately Owned Sites for Welfare Uses (Special Sites Scheme) have been completed, which will provide new services including some 260 elderly services places (with 100 subvented places). The remaining projects under the Special Sites Scheme are at various development stages. (9) The Elderly Commission (EC) completed and submitted the Elderly Services Programme Plan (ESPP) to the Government in June 2017, proposing four strategic directions and 20 recommendations on the future development of elderly services. The Government has accepted in principle the strategic directions and recommendations in the ESPP. Apart from regularly reporting to the EC, the Government will brief Members of the Legislative Council Panel on Welfare Services on follow-up action arising from of the recommendations of ESPP. (10) "Ageing in place as the core, institutional care as back-up" is the Government's policy direction in elderly services. Therefore, the Government has been increasing service places of community care services over the years. Since 2017, the Government has increased the total service place of IHCS(FC) and EHCCS from 8 365 to 13 365, the number of vouchers under the Pilot Scheme on Community Care Service Voucher from 3 000 to 8 000, and the number of places of day care services from 3 059 to 3 732.