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Following is the speech by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, on policy areas of food safety and environmental hygiene, health services and welfare services during the debate on the Motion of Thanks in respect of the Chief Executive's 2003 Policy Address in the Legislative Council today (January 16) (English only):

Madam President,

The Chief Executive has announced the Policy Agenda under five guiding principles, one of which is a "Caring and Just Society". I wish to thank Members for expressing their views on this important topic, and would like to take this opportunity to respond to the points raised.

The multi-pronged approach espoused by the Chief Executive in his recent Policy Addresses, of fostering economic growth, facilitating human investment and increasing social investment together, provide the best environment for people to leave the poverty net. Healthy economic recovery and a broader economic base is the key to lifting the standard of living for all, including those with no or little income.

Human and social investment through education, training and retraining will raise the capability, productivity and competitiveness of our workforce, and help those unable to benefit from the changing economy in the short term. By providing opportunities for upward social mobility, everyone by exercising their talents and by working hard can raise their income, improve their standard of living and climb up the social ladder over time.

In the face of the impact brought about by the necessary economic restructuring, our focus must be on fostering an environment which encourages and provides opportunities for upward social mobility. At the same time, to take care of the socially vulnerable, in particular those with limited capability to achieve this upward social mobility, specific help is required. To achieve this, we have in place various policies and programmes to secure an individual's basic standard of living, to help them improve their position and to provide them with opportunities for economic and social participation. In this way, we help the socially vulnerable, by enhancing, not impeding, their will to be self-reliant. To do otherwise would not be in the individual's nor the community's longer-term interest.

Before embarking on specifics, I should like to say a few words about our social philosophy since this will enable Honourable Members and the community to understand and see the Government's policies and programmes in the right context. Our vision for a "Caring and Just Society" celebrates the rich diversity of our community, recognising that each individual is endowed with different strengths. We aim to create an environment in which all people including, the socially disadvantaged are provided with equal opportunities to develop their potential to the full thereby enabling them to participate and contribute to our economic and social life. The Government sees its primary role as helping people to enhance their ability to help themselves and to boost their will power to do so. In this regard, it assists people to deal with challenges and difficulties which arise, thereby enabling them to participate fully in and contribute to, the life of the community.

By way of elaboration, I wish to highlight four pillars of our social philosophy which embrace the specific social programmes, the Government pursues and members of the public benefit from, every day. Firstly, our investment in the different domains of human development providing opportunities for every person to develop his or her potential and enabling all to participate in and contribute to, the economic and social life of Hong Kong. Secondly, to fulfill our special social responsibilities to the disabled, the disadvantaged and vulnerable members of our community, by providing specific targetted programmes, additional support and targetted assistance to enable them in particular to develop their potential and participate fully in the life of the community. Thirdly, for individuals who are economically inactive because of age, illness or disability, and for individuals who are in need of financial assistance because of unemployment, we ensure that our social security schemes provide a safety net to meet their basic needs and help those able-bodied recipients gain self-reliance. And finally, our determination to strengthen the social fabric of our community by fostering mutual care and support, and building the social networks necessary for both individuals and families to flourish.

It is important that we continue to invest in the human development of each person, with the clear objective of providing the resources necessary for people to ultimately help themselves. The approach we adopt is integrative, longitudinally throughout an individual's life and horizontally, coordinating the different dimensions to accommodate the unique circumstances of each individual.

The primary structure for achieving this lies in our health, education and other social services. To take one example. On the health front, we recognise the importance of linking together and supporting the critical stages of human development and life events - the physical, psychological, emotional, social and spiritual health needs. The investment is throughout the life of an individual. For example, in terms of influencing the state of health of parents at the time of conception, the early childhood and adolescence development. And throughout these early formative years, the educational sector, which also benefits from substantial Government investment, has a vital role to play in developing and nurturing the cognitive skills of the young. This in turn, is supported by our many welfare programmes which provide services for all groups and specific disadvantaged sectors which complement the work of the education sector. Collectively, these programmes in the health, education, housing and welfare sectors provide support to individuals in need, throughout their lives where necessary, but always with the objective of enabling them to achieve self-reliance.

In doing so, we recognise that individuals are not starting on the same footing and the situation of each person differs. Indeed, many vulnerable groups have their own special strengths which we must encourage and develop. Areas of weakness need to be addressed and arrangements made to support individuals. All of this is done with a view to enabling them to contribute to and benefit from, the wealth generated by society as a whole. In this context, the Government's role is one of an enabler or facilitator. As our guiding principle in developing social services is to build a caring community based on self-sufficiency, dignity, harmony and happiness. Multiple and different, but complementary programmes and approaches are required to enable the strength and the ability of each person to flourish and grow. With this support, people will be better able to take responsibility for themselves and their families.

Hong Kong is a caring and compassionate society underpinned by the important pillars of the family and the community. The family remains a vital component and its successful functioning is one of the best guarantees for an individual to be able to contribute positively to the community. We are obviously very sensitive to the plight of individuals in the community who face adversities in the new economic order through, for example, the loss of jobs or relationship problems. However, the family should always be the resource of first resort for an individual. The warmth and stability of relationships within families however constituted, is what counts in nurturing and supporting its members. There is no substitute for an effective functioning family. Government is certainly not a substitute. In addition, the community's social network can play a vital role in providing further support and help individuals to ride out the difficulties and challenges faced. In this context, the Government's role is a supportive one. I see it as our responsibility to strengthen family solidarity, enhance partnerships amongst various sectors and foster mutual care and help in the community so that individuals are embedded in a network of care, trust, support and reciprocity. All must work together to ensure that no individual is left alone to face adversity. And every member of society should be prepared, especially during these difficult times to offer mutual help and support to each other. By coming together, much more can be achieved as any team player knows.

The Government is taking an active role to encourage and facilitate stronger bonds between the Government, NGOs and the business sector with the specific aim of fostering mutual care and help throughout the community. Indeed, this was the thinking behind the launch of the $300 million Community Investment and Inclusion Fund last year. The promotion of volunteerism is also an important tool in furtherance of this aim and I am pleased to see that more and more people in the community are participating whether in terms of giving their time or money. Taken together, these contribute greatly to building up our stock of social capital which should be regarded alongside our economic capital, as a much valued community asset.

Investments to promote and enhance the functioning of the family and to build up social capital generate long-term and valuable gains for society and should therefore never be undervalued.

This year, the Chief Executive has talked about shared responsibility to tackle the fiscal deficit. Alongside this, he has firmly reiterated our continued commitment to assist those in need of support and to take care of the disadvantaged in our community.

Over the years, we have made substantial investments in our social services. Recurrent expenditure on our health and welfare programmes has risen from $26 billion and $20.3 billion respectively in 1997-98 to $32.4 billion and $32.1 billion respectively in the fiscal year 2002-03. If we also take account of housing and education programmes, Government's expenditure this year in the four programme areas will account for about 57 per cent of total recurrent public expenditure.

Clearly, the fiscal deficit problem must be addressed now and tackling this issue will be one of the Government's top priorities. If public expenditure continues to grow unchecked, we will have no alternative but to keep on raising taxes and increasing fees, thereby channelling more and more resources to the Government. Such a move may result in less efficient use of community resources and a deteriorating business environment. Therefore, it is not realistic to expect the substantial growth in expenditure on social services in the past decade to continue.

As I told Honourable Members on Monday in the Welfare Panel, our priority is to rationalise, re-organise and re-engineer them so as to make the most efficient use of limited resources. Over the next months, we will critically examine how best to achieve the savings whilst minimising the impact on the community.

I should now like to briefly highlight some practical examples of the specific measures which the Government has put in place to help provide opportunities for individuals to fulfill their potential. My focus will be primarily on the welfare programme and I begin with social security, which many Honourable Members have referred to.

The Government is committed to providing a safety net to look after those least able to look after themselves, including the elderly, the ill and the disabled. Over the past year, social security spending has increased by eight per cent and it now accounts for 11 per cent of Government recurrent expenditure.

Our social security schemes are non-contributory and funded from General Revenue. The Chief Executive made clear in his Policy Address that the Government would maintain a simple and low tax regime. We therefore have a responsibility to ensure that our safety net, particularly the Comprehensive Social Security Assistance (CSSA) Scheme, is effective and sustainable in the long run and that limited public resources are used in the most optimal manner to meet the community's needs.

Over 30 per cent of CSSA cases involve able-bodied adults. It is Government's objective to support, not impede their will for self-reliance. To ensure CSSA can serve as a springboard to self-reliance, we will intensify our existing support measures to enable the CSSA recipients go back into the workforce.

As regards support for needy elders, at present over 600,000 older persons are receiving financial assistance through either the CSSA or Old Age Allowance (OAA), with an estimated expenditure of $11.8 billion in 2002-03, representing an increase of about 50 per cent compared to the year 1997-98. Our objective is to develop a long-term sustainable financial support system that better targets resources at elders most in need, drawing reference from the "Three Pillar Approach" recommended by the World Bank for old age financial protection. So contrary to some members' views as expressed in this debate, we are in fact looking at this income protection for older persons.

CSSA and Social Security Allowance (SSA) rates have remained frozen since 1999, despite continuous deflation. We informed the Finance Committee of this Council that the rates would remain frozen until March 2003, pending a review of the payment rates and related matters. We have explained on various occasions to Honourable Members that there is room for a deflationary adjustment of 11.1 per cent in the standard payment rates in accordance with the established adjustment mechanism, based on the movements of the specially complied Social Security Assistance Index of Prices. So this reflects what is actually required by our social security recipients and is not the general consumer price index. It is specially compiled Social Security Assistance Index of Prices to reflect the needs of the CSSA recipients. The adjustment is meant to restore the buying power of the benefits to their originally intended level to provide a basic standard of living to meet basic and essential needs. It is not and should not be regarded as a welfare cut because it maintains the same purchasing power to maintain the standards of living intended by the CSSA Scheme.

The 1996 CSSA Review examined the adequacy of CSSA rates for different categories of recipients. So, this is one of the points that Members raised in the motion debate earlier. The findings showed that CSSA rates for the elderly were adequate to meet recipients' basic and essential needs. Since then, elderly recipients living in a family were given an increase of $180 from April 1996 in their standard rates. The standard rates for the elderly were also increased by $380 in April 1998 to encourage them to participate in more social activities. All in all, with inflationary adjustments and real improvements made in recent years, CSSA payments for the elderly should provide for a better than basic standard of living. In addition, CSSA elderly recipients also receive free medical services in public hospitals and clinics. There is also a very well established network of welfare services for older persons in Hong Kong providing heavily subsidised community and home-based support, including home help and meal services.

The majority of our elderly are independent and healthy. For those frail elders who have long term care needs, we are committed to providing them with quality and cost-effective care, and appropriate support for their carers.

The objectives of our family and child welfare programme are to preserve and strengthen the family as a unit, to develop caring inter-personal relationships, to enable individuals and family members to prevent personal and family problems, to deal with them when they arise, and to provide for needs which cannot be met from within the family. At an annual expenditure of $1.8 billion, this programme provides a comprehensive range of services, including casework, life education and various support services for special family groups. We will continue to strengthen and support the family in a more comprehensive, effective and client-oriented manner. As outlined in our Policy Agenda, under the direction of a child-centred, family-focussed and community-based approach, we will continue to develop a new service delivery model in the form of integrated family service centres, which comprise Family Resource Unit, Family Support Unit and Family Counselling Unit. Together, these provide a continuum of preventive, supportive and remedial services. The aim is for family services to be made more accessible to families in need, to better identify problems early and intervene appropriately, and to better identify and meet the different needs of different families.

The objective of our youth welfare programme is to help young people, in particular those at risk, to become responsible and contributing members of our society. At an annual expenditure of $1.3 billion, this programme provides a full range of developmental, preventive, supportive and remedial services to assist our young people to reach their full potential and become responsible and contributing members of the society.

The objective of providing suitable rehabilitation services, support and assistance to people with disabilities is also to enable them to develop their potential and participate fully in the community. At an annual expenditure of over $16 billion, this programme ranges from education and training to employment, transport, community and residential care. As outlined in our Policy Agenda, we will, in particular, improve accessibility for people with disabilities by enhancing guidelines for barrier free access. Recognising the importance of full participation of people with disabilities in the community, the Government has drawn up an action plan to develop in a progressive manner, a barrier-free environment for them. Continuous improvements will be made to enhance accessibility of buildings, roads etc. as well as the public transport system.

Turning to health, our policy objective on health services is to develop and maintain in Hong Kong a health care system which protects and promotes the health of the population, which provides lifelong holistic care to each citizen at affordable prices, and which is financially sustainable in the long run.

Members will remember in our consultation document issued in the year 2000. We had three strategies for long-term financing. The first was to continue to improve productivity in the public sector and the measures that the Hospital Authority are pursuing are really consistent with these productivity measures. They are in no way cost cutting measures. They are really making sure that the finite resources that we have available continue to meet the needs of the community in response to changing technologies and changing ways of delivering services. So the closure of certain institutions should not be a concern if they are no longer needed. So these are the issues that the Hospital Authority are dealing with.

The second component of the long-term financing strategy relates to better targetting of our subsidies for public hospital services and this is reflected in the proposed fee restructuring exercise that we introduced to Members earlier this year.

The third would be a longer-term financing system. As we have discussed previously, there are really limited options. The social insurance proposed by the Harvard consultants was rejected by almost every sector of the community. The only option left really is the Health Protection Account which is a saving scheme because voluntary medical insurance has not been shown to be an effective mainstay public financing system in any part of the world. We will certainly come back to this Chamber again later when we have completed our studies for the Health Protection Account. We can certainly revisit the option for longer-term financing because as I have said in the Health Services Panel in the past, we are quite open in terms of revisiting which options are best for Hong Kong but certainly the options are limited.

In the restructuring of the fees and charges in public hospitals and clinics, we have ensured that fees continue to be affordable to all sectors of the community to ensure that no one would be denied adequate medical treatment because of lack of means. We have an effective fee waiver system which ensures that the socially disadvantaged and financially vulnerable who have difficulty paying even for the currently highly subsidised medical fees and charges are not denied of appropriate and adequate medical care.

Maintaining good health is a personal responsibility. The promise of good health cannot be achieved without the individual's personal actions and contributions through early planning for the individual's long-term health care needs and the adoption of health-promoting behaviours and lifestyles. The Government's role in preventive care is to provide the necessary information, encouragement and infrastructure to enable people to control and improve their own health. We will continue to oversee the development of preventive care, identify and assess the impact of social and environmental variables to health, protect health through legislation and regulations, provide services ranging from disease surveillance and prevention, health education and promotion, to immunisation and health screening.

Over the last year and in the next few years, the services which the Department of Health provides for expecting mothers, babies, adolescents, women, men and elders will be re-engineered into a life-course approach, strengthened and expanded to enable a wider coverage in the community, and new services added to enrich the comprehensiveness of the health promotion programme.

In addition, we will also take forward other important issues such as -

*regulating and developing Chinese medicine and introducing Chinese medicine into the public health care system.

*ensuring that the public enjoy a smokeless environment in work and other public places through amendments to the Smoking (Public Health) Ordinance.

*protecting the public from misleading or untruthful claims through amendments to the Undesirable Medical Advertisement Ordinance.

*safeguarding the health and safety of the public by developing a regulatory framework on the supply and use of medical devices.

On women, the Government is committed to promoting the well-being and interests of women in Hong Kong. On the advice of the Women's Commission, we have adopted a three-pronged strategy of gender mainstreaming, empowerment of women and public education in order to create an enabling environment to develop women's full potential and to build up their capacity.

In respect of gender mainstreaming, we will seek to incorporate women's needs and perspectives into Government's policy making, implementation and legislative processes, where appropriate, by means of an analytical tool. And, we shall continue to collaborate with local tertiary institutions to provide gender-related training to civil servants to enhance their sensitivity towards gender issues and women's concerns and to facilitate their gender mainstreaming work.

An important part of the empowerment process is to facilitate women's full and active participation in all aspects of community life and decision making processes, and participation in Government advisory and statutory bodies is a crucial aspect of community involvement. We will work with other Bureaux to enhance women's participation in these bodies. This will allow the views of both genders to be more fully reflected and considered.

As part of our efforts to create an enabling environment, we are working with the Women's Commission to launch a public education programme to raise public awareness of gender issues and to reduce gender stereotyping and deep-seated misconceptions about the roles, values, images and abilities of the two sexes.

During this debate, a number of Members have voiced comment over the recurring avian influenza outbreaks. I would like to stress that avian influenza virus exists in nature and cannot be eliminated altogether. As long as we have live chicken trading at the retail level, there will be a risk of avian influenza occurring. Our strategy is to minimise the risk of outbreaks at all levels and certainly to prevent any of these to spill over to affect human health. We have in place a comprehensive and sensitive surveillance system to detect the presence of the virus. We also have a package of measures to prevent the virus from entering the production and marketing chain as far as possible. We constantly review these measures to see if and how we can further improve our preventive capability in the light of the changing environment.

Because of the endemic nature of the disease, depolulation is no longer the only course of action to take in dealing with an outbreak situation. We have deployed other measures such as placing the affected birds under quarantine, extending the vaccination scheme to the rest of the birds in affected farm and the birds in the surrounding farms, etc. These measures have been effective in containing the spread of the disease.

This should not be seen as being unfair to the farmers as they also have a very pivotal role to play to prevent their farms from being infected by implementing and maintaining heightened biosecurity standards. In the Food Safety and Environmental Hygiene Panel earlier this week, I did report to members that in fact when I visited New Zealand a few months ago, they did not even permit me to go to the poultry farms because they required any visitor to be quarantined for a week before they could visit a farm. This was a requirement not laid down by the Government but by the trade itself. Because the trade is very concerned about their own standards of biosecurity to make sure that infections are not brought in. So the primary responsibility for keeping avian flu out is not the Government's, it is the trade itself. In the event that individual farmers have encountered financial difficulties, the Agriculture, Fisheries and Conservation Department stands ready to provide assistance by making use of the existing loan scheme to tie them over a difficult period.

Some Members have also questioned whether we should have a comprehensive vaccination of all chickens in Hong Kong as the solution to the avian influenza problem. It is important to note that it is internationally recognised that the mainstay of measures to deal with avian influenza should be heightened farm biosecurity, stringent hygienic practices in farms and markets, and an effective surveillance system. Vaccination is normally used in containing outbreaks but should not be seen as the only and ultimate solution to tackle the problem of avian influenza. This view is shared by members of the Expert Working Group on Avian Influenza when they recently reviewed the interim results of the trial of vaccination. I would also like to reiterate that we have not yet completed the trial of vaccination, which will provide us with the information to evaluate the effectiveness of this component strategy in the current environment.

We will also seek to improve overall food safety by adopting a multi-pronged approach. We will introduce legislative changes to bring our food laws up-to-date following the recommendations and standards of Codex, the international authority for food standards. Our current plans include introducing legislative amendments to require labelling of allergens and food additives and mapping out the way forward on nutrition labelling.

We will also regularly review our enforcement priorities and strategies to tighten up regulatory control over unhygienic food establishments in the interests of public health. The new legislative amendments when they come into force next month, will empower the licensing authority to close expeditiously unhygienic food establishments which pose serious and immediate threat to public health.

We will also seek to improve the effectiveness of our public education programmes and education of the food trade. As the most effective approach to food safety is to tackle potential problems at source, we will also improve the control on agricultural and fisheries operations that have an impact on public health or the environment. Our current plans in this regard include the introduction of legislation to implement a fishing vessel licensing system and to improve the control on the use of pesticides. We also intend to review some of the licensing practices in our Food and Environmental Hygiene Department as we have undertaken to the Panel.

Time does not permit me to be exhaustive in terms of detailing all of the Government's initiatives. Honourable Members will be aware that our other social service policies and programmes in the health, education, housing, labour and women's arenas also contribute to our underlying philosophy of assisting people to develop their full potential. Our efforts go far beyond only providing a basic safety net. We provide much more as we help people to move to independence.

I have outlined the thinking and rationale behind our social service policies and programmes. All of these, the Government regards as an investment in our people. The future holds many challenges for us all but I firmly believe that these will also create opportunities, which if suitably taken up will enable the community, as a whole, to optimise its human and other resource potential.

Thank you.

End/Thursday, January 16, 2003

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