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LCQ7: Subsidised care-and-attention places
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     Following is a question by the Hon Leung Kwok-hung and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (April 1):

Question:

     I often receive complaints from elderly people and organisations pointing out that the current acute shortfall in the supply of subsidised care and attention places for the elderly (C&A places) has resulted in rather long waiting time for such places.  On the other hand, as the quality of the services provided by private residential care homes for the elderly (RCHEs) varied, they are not well received by the elderly people and hence the occupancy rates of such RCHEs are persistently on the low side.  Those elderly people and organisations have also pointed out that the Government's faulty planning policy on care services of RCHEs has led to "collusion between business and the Government" and "transfer of benefits".  In this connection, will the Government inform this Council:

(a) of the respective average waiting time of elderly people currently living in the community and private RCHEs for subsidised C&A places, broken down by District Council districts (excluding cases of elderly people waiting for admission to homes of their choice and cases of those being given priority allocation on grounds of special circumstances);

(b) of the current respective numbers of elderly people who choose to wait for admission to the Chi Lin Nunnery Chi Lin Care and Attention Home in Wong Tai Sin, the Hong Kong Chinese Women's Club Madam Wong Chan Sook Ying Memorial Care and Attention Home for the Aged in Kwun Tong and the Hong Kong Sheng Kung Hui Li Ka Shing Care and Attention Home for the Elderly in Sham Shui Po (excluding elderly people who are given priority allocation on grounds of special circumstances), and the average waiting time for admission to each of the RCHEs;

(c) of the respective numbers of elderly people in each of the past five years who died while waiting for the Enhanced Bought Place Scheme (EBPS) places and other subsidised C&A places;

(d) among the 650 additional subsidised residential care places to be provided in the current financial year, of the respective numbers of those to be provided by non-governmental organisations (NGOs) as well as EBPS places, and whether the Labour and Welfare Bureau, the Social Welfare Department and the Elderly Commission (EC), especially EC members who are operating private RCHEs, have jointly planned for the number of places to be allocated to these two types of homes;

(e) whether the Government will immediately redirect the additional funding to be allocated to EBPS to C&A places provided by subvented and contract RCHEs so as to shorten the waiting time for these places; if so, when it will implement this arrangement; if not, of the reasons for that, and whether it has assessed if the provision of additional resources to EBPS every year involves "collusion between business and the Government" and "transfer of benefits"; if so, of the assessment results; and

(f) whether the Government will consider granting sites in the next three years for constructing detached buildings to be used by NGOs for operating subsidised RCHEs; and whether it will consider allocating funds to fully subsidise RCHEs currently located in detached buildings to build additional storeys so as to optimise the use of land, increase the number of subsidised C&A places and create employment opportunities; if it will grant such sites and funding, when it will implement the plans concerned; if not, of the reasons for that?

Reply:

President,

     Promoting "ageing in the community" is one of the underlying principles of the Government's elderly policy.  Hence, the Government has allocated considerable resources to support elders to age in the community.  It is worth noting that not all elders with long-term care (LTC) needs have to stay in residential care homes, and not all elders with LTC needs require subsidised residential care services.  With adequate community care and support, elders with LTC needs can continue to age at home as they wish.

     My reply to the question is as follows:

(a) At present, all applications for subsidised residential care services are managed under the Central Waiting List for Subsidised Long Term Care Services on a territory-wide basis.  There is no separate waiting list for individual districts and therefore the Social Welfare Department (SWD) cannot provide a breakdown of the waiting time by districts.  Since the accommodation status of elders while waiting does not affect their waiting time, SWD does not separately compute the waiting time for elders living in the community or private residential care homes for the elderly (RCHEs).

     As at end-February 2009, excluding cases where elders have specific requirements on the RCHEs they are waiting for, i.e. those who have requested to be admitted to specific RCHEs, or RCHEs in designated locations, as well as the priority cases, the shortest waiting time for subsidised care-and-attention (C&A) places was one month while the average was 12 months.

(b) As at end-February 2009, among the applicants waiting for subsidised C&A places, there were 416, 163 and 524 elders specifically requested to be admitted to the Chi Lin Nunnery Chi Lin Care and Attention Home, the Hong Kong Chinese Women's Club Madam Wong Chan Sook Ying Memorial Care and Attention Home for the Aged, and the Hong Kong Sheng Kung Hui Li Ka Shing Care and Attention Home for the Elderly respectively.  SWD does not separately record the waiting time for individual RCHEs.  The waiting time for specific RCHEs varies under different circumstances and is affected by many factors, including the number of residential care places in the concerned RCHEs that are available from natural wastage, the number of elders chosen to wait for the concerned RCHEs during the same period, and the genders and preferences of elders waiting for specific RCHEs, etc.

(c) As elders can choose to wait for subsidised C&A places in different types of RCHEs (including subvented/contract RCHEs and RCHEs participating in the Enhanced Bought Place Scheme (EBPS)) in parallel, SWD does not keep separate statistics on the numbers of elders who passed away while waiting for different types of RCHEs.  The numbers of elders who passed away while waiting for subsidised C&A places in the past five years were 2,151, 2,053, 2,159, 2,449 and 2,556 respectively.

     It is important to note that elders waiting for subsidised C&A places can also opt for government-subsidised community care services in the interim.  Generally speaking, elders can be allocated with subsidised community care services that suit their needs within a relatively short period of time.  Besides, some elders may choose to stay in private RCHEs while waiting for subsidised C&A places.  If these elders require financial assistance, they may apply for Comprehensive Social Security Assistance (CSSA) to meet the relevant expenses.

     As at end-February 2009, among the elders waiting for subsidised C&A places, about 53% (i.e. 9,526 elders on the waiting list) were receiving various kinds of government subsidies or services, including:

(i) 2,120 elders (12%) were using subsidised community care services;

(ii) 351 elders (2%) were using subsidised residential care services of a lower care level;

(iii) 4,463 elders (25%) were staying in non-subsidised residential care places in private RCHEs and receiving CSSA; and

(iv) 2,592 elders (14%) were staying at home and receiving CSSA, but were not using subsidised community care services.

(d) The 2009-10 Budget has earmarked recurrent funding of $55 million (full year effect) to increase the supply of subsidised residential care places, including:

- $17 million for providing some 150 additional subsidised residential care places (with 70% nursing home (NH) places and 30% C&A places) in two newly built contract RCHEs.  SWD will continue to award contracts for operating these RCHEs through open tender; and

- $38 million for purchasing 500 subsidised C&A places from private RCHEs through EBPS.

     The main task of the Elderly Commission (EC) is to advise the Government on the formulation of a comprehensive elderly policy.  The Government has consulted EC prior to the introduction of EBPS and the contract approach in operating RCHEs.  The additional number of residential care places to be provided every year and its allocation (including additional places to be provided through contract RCHEs and EBPS) are determined by the Labour and Welfare Bureau and SWD, after considering various factors including elders' demand for different subsidised LTC services, availability of resources, and the time required for identifying and constructing contract RCHEs, etc.  EC is not involved in the process of allocating residential care places.

(e) SWD launched EBPS in 1998 with a view to increasing the supply of subsidised C&A places and encouraging private RCHEs to enhance their quality of care through purchasing places from the private market under a fair and transparent mechanism.  Under EBPS, SWD will invite all private RCHEs to submit applications and will select suitable RCHEs to join the scheme based on a set of open assessment criteria.  The criteria cover various aspects, including the environment, facilities, service quality and management of the RCHEs, their past records (for instance, the number of warnings and advisory letters received from SWD), and the demand for residential care places in the districts where the RCHEs are located.

     A characteristic of EBPS is that once a private RCHE participates in the scheme, the same enhanced standards (e.g. staffing and bed spacing requirements) will apply to the entire home (including non-subsidised places).  The introduction of EBPS represented an important step forward in enhancing the quality of private RCHEs.  The Government will continue with the two-pronged approach, i.e. by purchasing places from private RCHEs through EBPS and constructing new contract RCHEs, in order to progressively increase the supply of subsidised residential care places.

(f) From now till 2011-12, SWD will conduct open tender exercises to select operators for five newly built contract RCHEs (including the two newly built contract RCHEs mentioned in the 2009-10 Budget).  Besides, SWD has earmarked sites in 12 development projects for the construction of new contract RCHEs and will proceed with the open tender process in phases to select operators for these RCHEs upon the completion of the RCHE premises.  These contract RCHEs are all purpose-built premises attached to residential or government/community development projects.

     Non-governmental organisations (NGOs) operating RCHEs in stand-alone buildings may apply to SWD for redeveloping or constructing additional storeys in the building if they wish to increase the number of residential care places.  In deciding whether to support such proposals, SWD will consider whether the redevelopment or extension can enhance the quality of service as well as the possible impact on elderly residents.  If the proposal is supported by SWD in principle, the NGO has to submit a formal application to the Lands Department (LandsD).  LandsD will examine proposals that involve change in plot ratio and/or land uses, and consult relevant departments before deciding on whether to approve the applications.  On the costs of extending or redeveloping the premises, SWD will, having regard to the need of individual NGOs and whether the redevelopment or extension projects will enhance the support for frail elders, etc., consider providing funding through the Lotteries Fund.  Based on the above criteria, SWD has just supported a feasibility study on the redevelopment of the David Trench Home for the Aged of the Tung Wah Group of Hospitals through funding approved by the Lotteries Fund Advisory Committee in March 2009.

     It is worth noting that these redevelopment or extension projects must conform with the provisions in relation to RCHE premises under the Residential Care Homes (Elderly Persons) Ordinance, including the provisions specifying that no part of an RCHE shall be situated at a height more than 24 metres above the ground floor; and no RCHEs shall be situated in any part of an industrial building or any premises located immediately above the ceiling or below the floor slab of any godown, cinema and theatre.

Ends/Wednesday, April 1, 2009
Issued at HKT 15:31

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