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Following is a question for the Hon Bernard Chan and a written reply by the Secretary for Health and Welfare, Dr E K Yeoh, in the Legislative Council today (April 5):

Question:

There are complaints that applicants for admission to subvented residential care homes for the elderly such as hostels, homes for the aged, care-and-attention homes and nursing homes, have to wait for a long time before such places are allocated to them. In this connection, will the Government inform this Council of :

(a) the respective numbers of applicants for admission to various types of residential care homes who had died before places were allocated to them in the past five years;

(b) the current waiting time for admission to each type of residential care homes for the elderly; and

(c) the measures it will take to shorten such waiting time?

Reply:

Madam President,

(a) The number of applicants who passed away while on the waiting list for different residential care places is about seven, 350 and 2,500 per year in the past five years for self-care hostels, homes for the aged and care and attention homes respectively. Social Welfare Department established six nursing homes in 1998 and the number of applicants who passed away while waiting for these homes in the past two years is about 800 per annum. The death rate is influenced by biological, medical and other factors and should not be seen to relate directly to the waiting time.

(b) The waiting time for different applicants will vary due to their health conditions and specific preferences. For those who are in urgent need, priority placement can be arranged within a few weeks, or even days, where emergency placement is justified. On the other hand, applicants who have indicated locational, home, religious or diet preferences, their waiting time will usually be longer than those who have not indicated any particular preferences. As at March 2000, on average, there was a waiting time of about five, 16, 22 and 12 months for application for places in self-care hostels, homes for the aged, care and attention homes and nursing homes respectively.

When interpreting the waiting time for residential care places, we should take note that not all applicants have an immediate need for residential care services. Under the existing practice, applicants are not required to undergo care need assessments before registration on the waiting list. Some of the elderly people on the waiting list (about 10%) are already receiving subsidized residential care services but are awaiting transfer to another residential care institution, providing a different level of care service.

(c) To shorten the waiting time for residential care, we are adopting a range of measures, as follows :

(i) According to a recent survey, only about 60% of the elderly people on the care-and-attention home waiting list are genuinely in need of residential care. We will put in place an enhanced gatekeeping mechanism by the summer of 2000 to target subsidized residential care service to the frail elderly with genuine need so that their waiting time can be shortened.

(ii) The Social Welfare Department will be introducing a pilot project on continuum of care in residential care homes. Residential care homes taking part in the pilot will be provided with additional resources to provide higher levels of care services for their frail elderly residents. This will reduce the need for transfer of elderly residents between residential care homes providing different levels of care. Overseas experience has also shown that upon implementation of the continuum of care funding formula, residential care homes are more inclined to admit frail elderly with higher levels of care needs, thereby reducing their waiting time for admission to residential care homes.

(iii) To accord with the wishes of the majority of our elderly population who prefer to be cared for at home, we will continue to expand and upgrade our home and community care services for the frail elderly. In 2000-01, an additional $99 million has been earmarked to provide additional home and community care services in districts of high concentration of elderly population. These services will provide an alternative to the frail elderly who might otherwise have to apply for admission to residential care homes.

(iv) In 2000/2001, a total of 2,510 additional residential care places will be provided to meet the residential care service need.

(v) We will continue to engage the private sector to encourage and facilitate them to provide quality residential care service to give more choices to families in the middle and higher income groups who are willing to pay for better quality services for their elderly members. This will help target our elderly residential care programme at those who are in need of subsidized service, thereby reducing their waiting time.

END/Wednesday, April 5, 2000

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