LCQ6: Measures to cope with an ageing population
22.3.2023

Following is a question by Dr the Hon Priscilla Leung and a reply by the Secretary for Labour and Welfare, Mr Chris Sun, in the Legislative Council today (March 22): Question: According to the Hong Kong Population Projections 2020-2069 released by the Census and Statistics Department, the percentage of the elderly population in the total population will increase to over 30 per cent in 2039. In this connection, will the Government inform this Council: (1) whether it has assessed the challenges to be brought about by the continued ageing of the population to social and economic developments in the coming five years; if so, of the details; if not, the reasons for that; (2) whether it has assessed the demand for medical resources (including medical expenditure, medical facilities and healthcare manpower) in the coming five years to be brought about by the continued ageing of the population, and actively prepared to meet such challenges; and (3) of the specific measures to be put in place by the Government in the coming five years to strengthen elderly care services, including home care services as well as services provided by day care centres for the elderly and residential care homes for the elderly? Reply: President, Same as many advanced economies, Hong Kong is facing the issue of ageing population. The issue of population straddles across different policy portfolios, and requires the concerted effort of the whole Government as well as the entire society. In response to the Member's question, I give the consolidated response on behalf of the relevant bureaux and departments of the Government as follows: (1) With a longer average life expectancy, a persistently low birth rate as well as the baby boomers gradually entering retirement age, the number and proportion of elderly persons will trend up in Hong Kong, making the ageing trend to be more prominent. According to the Census and Statistics Department's population projection, the percentage of elderly persons aged 65 and above in the total population will gradually increase from 20.8 per cent in mid-2022 to 25.3 per cent in 2028, and then to 35.1 per cent in 2069. Meanwhile, given a lower labour force participation rate for the elderly persons, it will be inevitable for the overall labour force participation rate to drop consequentially. Manpower resources is one of the key elements for local economic growth. In the event of a dwindling labour force, it will likely impede the potential of economic growth. In this connection, the Government has implemented an array of measures to trawl for outside talents alongside its efforts to nurture local talents, so as to contribute to our economic development. Meanwhile, a continued rise in the number of elderly persons will increase the demand for various elderly and healthcare services. To this end, the Government will continue to improve elderly services with due emphasis on both quality and quantity, follow through with the policy direction of promoting "ageing in place as the core, with institutional care as back-up", and endeavour to provide diversified services to elderly persons in need. The Government will also address the challenges brought by an ageing population and an increasing prevalence of chronic diseases through various measures, including the promotion of primary healthcare and the improvement of public hospital services. (2) Ageing population and increasing prevalence of chronic diseases are the major reasons for the increase in the occurrence rates of chronic diseases. It is expected that the chronic diseases and their associated complications would exert a heavy toll on secondary and tertiary medical services, especially on the public hospital system. In the face of the pressure brought by an ageing population and chronic diseases, the Government released the Primary Healthcare Blueprint in December 2022 to strengthen primary healthcare. The objective of the Blueprint is to shift the focus of the current healthcare system from curative treatment to prevention of diseases, thereby improving the overall health status of the population, providing accessible and coherent healthcare services, and establishing a sustainable healthcare system. While the demand for medical services may not be reduced in the short run, improving primary healthcare services will help alleviate the pressure on the secondary and tertiary medical services in the longer run. For secondary and tertiary medical services, the Hospital Authority (HA) plans and develops public healthcare services on a cluster basis, taking into account a number of factors, including the increase of service demand as a result of population growth, demographic changes, rising prevalence of chronic diseases, technology advancement, manpower availability as well as the organisation of services of the clusters. The HA will monitor the utilisation of different medical services and make plans for public medical services according to the population projection of various districts in Hong Kong and development plans of the Government. For medical facilities, as announced in the 2022 Policy Address, the Government will press ahead with the First Ten-year Hospital Development Plan (HDP), adding about 4 600 beds and about 80 operating theatres in the next five years; and will include the development of a hospital network in the Northern Metropolis under the Second Ten-year HDP for catering to the projected service demand. For the supply of healthcare professionals, the Health Bureau has, since 2017, conducted manpower planning and projections once every three years, covering the 13 healthcare professions subject to statutory registration, namely doctors, dentists, dental hygienists, nurses, midwives, Chinese medicine practitioners, pharmacists, occupational therapists, physiotherapists, medical laboratory technologists, optometrists, radiographers and chiropractors to help understand the latest demand and supply of the healthcare professionals, and implement measures in a timely manner, including appropriate adjustments in training quota. (3) In terms of supporting ageing in place for the elderly, the Social Welfare Department (SWD) will regularise the Pilot Scheme on Community Care Service Voucher for the Elderly in the third quarter of this year to gradually increase the number of beneficiaries from the current 8 000 to 12 000 in 2025-26. It will also set up 16 new Neighbourhood Elderly Centres starting from this year to 2027. As for day care services, the Government plans to provide an additional 900 service places in the coming five years. The Government will also expand the HA's Integrated Discharge Support Programme for Elderly Patients in the third quarter of this year by increasing the number of beneficiaries by one-third to 45 000 per year. As for residential care services for the elderly, the Government is making its greatest effort to increase the number of service places by forging ahead the Enhanced Bought Place Scheme, Government contract home development projects that are being implemented as well as projects under the Special Scheme on Privately Owned Sites for Welfare Uses that have entered construction or detailed design stage. It is the Government's target to provide an additional 6 200 subsidised residential care places by end-2027, of which 2 600 will commence service by the end of this year. Furthermore, the SWD has increased the number of beneficiaries under the Residential Care Service Voucher (RCSV) for the Elderly from 3 000 to 4 000 in 2022-23, and will regularise the RCSV Scheme in April this year as well. To conclude, it is undisputed that the number and proportion of the elderly population had been increasing gradually. The measures summarised above should enable the Government to provide more appropriate healthcare, care and support services for the elderly with a view to creating a healthy ageing environment for the elderly persons. In 2023-24, the Government's estimated recurrent expenditure on elderly persons has reached $123.1 billion, which is 70 per cent higher than the $71.0 billion in 2017-18, and in turn demonstrates the Government's commitment to the elderly amid an ageing population.