The following is a speech by the Secretary for Health and Welfare, Dr E K Yeoh,at the Opening Ceremony of the "Conference on Repositioning the State: Challenges and Experiences of Social Policy in the Asia Pacific Region" today (April 25):
Distinguished Participants, Ladies and Gentlemen,
I am delighted to be with you today at this "Conference on Repositioning the State: Challenges and Experiences of Social Policy in the Asia Pacific Region". With the advent of the new Millennium, it is indeed timely to re-examine the parameters which affect our social policies and to consider how these should evolve in future, to best meet the needs of our communities. During the Conference, many speakers will share their research and insights on a wide range of issues from which all of us can no doubt benefit. As such, I should like to thank the organizers for arranging this Conference and for allowing us time to reflect on these critical issues.
It is said that "Social policy is any policy developed at supranational, state, local, or community level which is underpinned by a social vision of society and which, when operationalised, affects the rights or abilities of citizens to meet their livelihood needs"(1). Social policies cover many areas of life, including social welfare, health, education, housing, etc. Each country, city, area etc develops its own social policies over time in the light of its individual specific characteristics including the aspirations of the people living within its boundaries.
Latest statistics(2) show that the population of the Asia-Pacific region will increase from 3,693 million in mid 1999 to 4,523 million in 2020. This will inevitably bring about new challenges to governments and at the same time, two new factors are increasingly affecting the way in which we live and which, I believe, will have an ever-significant impact on social policy. Increased globalisation means greater inter-state interaction and interdependency. Isolationism is dead. And technological advancement particularly, in terms of information technology and e-commerce, will open new opportunities and present challenges for the delivery of social services, throughout the Region. These factors must, in future, be taken into account when social policies are devised.
It would be useful if I said a few words about some of our experiences in Hong Kong and highlight some of the challenges which we face in the months and years ahead. For the sake of simplicity and time, I shall focus on the policy areas for which I am responsible. However, many of the trends and changes envisaged apply equally to other areas of social policy.
Experiences and Challenges
In the last few years of the twentieth century, Hong Kong underwent a number of significant and fundamental changes.
Politically, with the return of sovereignty to China and the establishment of the HKSAR on 1 July 1997, the capitalist system and policies continue to be practised here under the principle of "one country, two systems". Residents' right to social welfare in accordance with the law, and the autonomy of the HKSAR Government to formulate policies on social welfare, are enshrined in the Basic Law(3) (which is Hong Kong's mini-constitution). In recent years, the public have had rising expectations over participation in the formulation of social policies and this has lead to greater demands for transparency and accountability in the process.
Economically, Hong Kong is a small open economy. As part of the global economy, the Asian financial turmoil swept over Hong Kong, making its impact felt in the form of negative economic growth, high unemployment, deflation and a depressed property market. This has inevitably resulted in the emergence of a number of social problems, although there was an inevitable chorus for government to intervene, there was an equally resounding voice from the community for the need for self-reliance, greater cost-effectiveness and productivity. The future accession of China into the WTO, will bring with it both opportunities and challenges for both China and Hong Kong. As such, we need to prepare ourselves for increased links with the Mainland including on the social services front.
Socially, a number of factors warrant our attention. Firstly, individuals aged over 60 are estimated to increase from 14.6% in 1999 to 19.7% by 2016. Unfortunately, with changing family structures and relationships, more and more elderly people are living alone. Secondly, the emerging concept of an "international extended family" with the heads or members of a family living, working or studying outside Hong Kong is increasing. Our population growth stems mainly from new arrivals from the Mainland rather than an increase in the local population, with the former expected to account for 57% of the population growth between mid-1997 and mid-2016. Another key feature is the increase in the divorce rate. Split or broken families are becoming more common in Hong Kong. Fourthly, the focus on monetary pursuits and alienation between individuals including within families, have resulted in a tendency to turn to the Government, rather than other individuals, families or the community, as the primary source for meeting social needs.
These have all in their unique ways, imposed pressures on us to cope with the new challenges and called for a rethink in many areas of social policy. This to be welcomed otherwise our social policies would not be able to adequately reflect the society in which we live and the needs and aspirations of the population.
Policy-makers cannot stay complacent and must be ready to break away from conventional paradigms and search for innovative ways to address the ever-changing needs of our community. I will now go into 5 key areas, with a view to providing some food for thought for your ensuing discussions -
(a) reforming the welfare subvention system;
(b) developing a strategic needs assessment mechanism;
(c) defining the roles of individuals, families, the community and the Government;
(d) strengthening inter-sectoral collaboration amongst various policy-makers and agencies; and
(e) reforming the health care sector.
(a) Reforming the welfare subvention system
Currently, the Government subvents 186 welfare agencies running over 3,000 welfare service units. In 2000-01, the amount of subvention will reach $6.4 billion.
For many years, both the Government and the Welfare Sector have been critical of the complex and bureaucratic systems of subvention. In response, the Government has now proposed a number of changes aimed at enabling more effective responding to the changing needs of our society, providing more cost-effective use of finite resources, promoting efficiency and encouraging innovation, and achieving greater accountability and transparency.
One key feature of the new system is to shift the focus of Government activity from managing inputs to providing strategic directions, defining priorities and outcomes and managing outputs. The prime concern should be the quality of services need by, and provided to, clients. Between April 1999 and April 2001, 19 specific Service Quality Standards and over 100 Funding and Service Agreements for all welfare service units will be introduced. These will more clearly define the roles, responsibilities and expectations of the Government as the provider of funds and of the NGOs as service providers. An enhanced Service Performance Monitoring System with specific output/outcome indicators together with a revised funding system and planning mechanism will also be put in place.
Following the successful experience with two pilot schemes in the way new welfare service units were allocated by competitive bidding, we see merits in gradually extending this arrangement. It will allow for benchmarking of costs and closer monitoring of performance which will in turn lead to enhanced service quality and cost effectiveness.
(b) developing a strategic needs assessment mechanism
In the new circumstances, we also need to be able to adapt quickly to meet the new and frequently changing needs particularly of the disadvantaged and vulnerable members of our society. We should no longer rely on a set of rigid planning ratios when planning welfare services. Instead, we should explore ways of developing a strategic needs assessment mechanism on the basis of evidence-based research. In this way, we can re-engineer our services and use our inevitably finite resources, to meet the most pressing needs of society.
(c) defining the roles of individuals, families, the community and the Government
The tasks ahead of us include arresting the emerging dependency culture and reverting to the traditional values of self-reliance which has served Hong Kong well; instilling cultural changes by refocusing from "individual values" to "community values" and cultivating civic responsibility and volunteerism in our population; strengthening the functioning of the family unit since family support rather than Government intervention is the preferred model for handling many social problems; and encouraging greater community participation and making fuller use of private sector resource in the provision of welfare services.
(d) strengthening inter-sectoral collaboration among various policy-makers and agencies
Clearly, it is not possible for welfare policy-makers to achieve these goals single-handedly. Given the complexities of modern-day life and the close interaction between different policy areas, there is a greater need for inter-sectoral collaboration. To cite an example, youth policies require the close co-operation of policy-makers and agencies involved in education, welfare and community-building.
(e) reforming the Health Care Sector
The Harvard Report released in April 1999 raised concerns over the long-term financial sustainability of our current health care system. It also pointed out that our current service delivery is also outdated. Following a 4-month public consultation, there is a clear consensus in the community on the need for reform.
Today, we are in the final stages of preparing a consultation document which sets out our proposed reform measures to our health care system. Whilst preserving the strengths of our current system, we need to address the challenges that lie ahead of us. For example, the rising cost of providing medical care in an aging community, increasing expectations from the community, etc. The reform of our health care system is not just about dollars and cents. It will be comprehensive in scope, addressing key issues in the areas of service delivery, assuring quality of care and long-term financing arrangements. Our objective is to ensure that all in our community have access to a sustainable, accessible, affordable and equitable health care system though a system of shared responsibility between the Government and every resident in Hong Kong.
The necessary change in mindset is not unique to Hong Kong. I have recently learnt that at the Shanghai-Hong Kong Conference on Socialising Social Service held in Shanghai in October 1999, participants shared the view that "the system of welfare services should be able to mobilise all kinds of resources (public and private) in the most effective way, motivate and incentivize service providers to be proactive, reflect the needs of people in a timely manner and provide more quality service at a comparatively lower cost". This succinctly summarises the challenges which lie before us in all social policy fields.
During the ensuing sessions, experts in many fields will be sharing their expertise and enriching our knowledge in individual policy areas. I trust all - the Government, NGOs, service recipients and the public - will benefit from this occasion.
In closing, allow me to wish the Conference every success and all participants a most interesting time and rewarding experience. For our visitors to Hong Kong, may I wish you a most enjoyable stay in this wonderful city.
(1) Overseas Development Administration (ODA) of the UK government (1995b) "Social Policy Research for Development". Report prepared for the ODA's Economic and Social Committee for Overseas Development at a seminar in 1995.
(2) 1999 Economic and Social Commission for Asia and the Pacific (ESCAP) Population Data Sheet.
(3) Article 36 provides that Hong Kong residents shall have the right to social welfare in accordance with the law.
Article 145 provides that on the basis of the previous social welfare system, the Government of the HKSAR shall, on its own, formulate policies on the development and improvement of this system in the light of the economic conditions and social need.
End/Tuesday, April 25, 2000