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Following is a question by the Hon Leung Kwok-hung and a reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (June 23):
Question:
In his reply to my question raised on the 9th of this month, the Secretary for Labour and Welfare advised that "the Government's elderly care policy is to encourage elders to 'age in place', which is in line with the wish of most elders and also the international trend", and its principle was supporting "ageing in place as the core, institutional care as back-up". However, many singleton elders have complained to me in tears about the acute shortfall in the supply of Integrated Home Care Services in the community, such as meal delivery, household cleaning and escort for medical consultation services. Moreover, although the utilisation rate of the day care centres for the elderly (day care centres) reached 110% in the 2009-2010 financial year, the Government has neither allocated more funding for such services, nor increased the activity space in those centres, resulting in over-crowdedness of the premises. Some elderly people have described such situations as being no different from asking them to "rest in peace in the community" and leaving those centres to "fend for themselves". In this connection, will the Government inform this Council:
(a) taking Kwun Tong, Wong Tai Sin and Sham Shui Po as examples, whether it has studied why singleton elders need to wait as long as 12 to 15 months before they can receive meal delivery service and services at the day care centres, and they receive household cleaning and personal cleaning services only once every two to three months and seven to nine days respectively; whether it has assessed if the policy of ageing in place is being implemented under such circumstances; and
(b) of the respective numbers of elderly people who died while waiting for the Enhanced Home and Community Care Services, Integrated Home Care Services or services of the day care centres in each of the past five years; whether the Government will immediately increase funding to enhance the services provided for the helpless elderly people in the community; if so, when this will be implemented; if not, of the reasons for that?
Reply:
President's Deputy,
An important principle of the Government's elderly care policy is to encourage elders to "age in place". To this end, the Government has been allocating resources over the years to enhance community care and support services for elders.
To ensure that resources are spent on elders who are most in need, the Social Welfare Department (SWD) has implemented the Standardised Care Need Assessment Mechanism for Elderly Services (the Mechanism) since 2000 to assess elders' abilities in taking care of themselves, their physical functioning, health conditions, and behaviour and emotion, etc., so as to ascertain their long-term care needs and to match elders with long-term care needs (usually referred to as frail elders) with appropriate services.
My reply to the Hon Leung Kwok-hung's question is as follows:
(a) At present, there are mainly two major types of community care services provided by the Government for frail elders: one is centre-based day care services and the other is home-based home care services.
Day care services cover personal and nursing care, rehabilitation exercises, meal and escort services, etc. Elders registered as service users can choose to receive full-day or half-day services in their respective centres according to their own conditions and needs. Since the elders may not visit the centres every day, the facilities concerned may not be fully utilised. In view of this, SWD usually sets the enrolment rate (not the "utilisation rate" as mentioned in the question) of day care centres at above 100% to encourage the centres to fully utilise their resources to serve more elders. Given the current service utilisation of the various centres, the enrolment rate is 110% on average. At the end of May 2010, the total number of service users was about 3,200, with about 1,100 other elders waiting for services. Their average waiting time was around 6.6 months.
As for home-based care services, service providers will draw up "individual care plans" for elders having regard to their conditions and practical needs, and provide them with a range of services such as personal care, basic and special nursing care, rehabilitation exercises, meal delivery, environmental risk assessment and home modifications. Since the conditions of each elder are different, the types and frequency of services will vary from person to person. In general, we can arrange home care services for frail elders within one to two months. This includes the time required for notifying elders and service providers, as well as that for service allocation. At the end of May 2010, there were a total of about 4,400 frail elders using home care services in the territory.
As for non-frail elders (i.e. elders without long-term care needs, with self-care ability or in better health conditions), they can choose to make use of the meal delivery, cleaning or personal care services provided by the Integrated Home Care Services teams. At present, there are about 17,000 elders using such services. As these are non-frail cases, applicants are not required to go through the Mechanism and service allocation is arranged by individual non-governmental organisations. In general, elders with urgent needs will be given priority in the allocation of service. In addition to the government-subsidised Integrated Home Care Services, elders can also choose to use similar home support services (e.g. meal delivery and home cleaning services) provided by quite a number of non-profit-making organisations and social enterprises in the community.
(b) In the years between 2005 and 2009, 8, 11, 14, 23 and 17 frail elders passed away each year while waiting for Day Care Services for the Elderly, Enhanced Home and Community Care Services and Integrated Home Care Services. We fully understand that frail elders have pressing service needs, and have therefore arranged services for them as soon as possible.
We will continue to enhance community care services to provide more timely and appropriate assistance for the elders. In fact, the resources we allocated for elderly care services substantially increased from $1.62 billion to $3.9 billion between 1997 and 2009, representing a rise of 140%. Of the total amount of resources, the proportion allocated for community care and support services accounted for about 40%.
I wish to point out that the number of day care service units has increased from 36 in 2001 to 59 at present. The service places have also increased from 1,420 to 2,314, representing an increase of 63%. In addition, we have earmarked recurrent funding of about $9 million in the 2010-11 Budget in order to provide a total of 115 additional day care places for the elderly. SWD will also redeploy resources to create 20 additional day care places in Tai Kok Tsui in 2012-13. We will continue to actively identify suitable sites for setting up day care centres for the elderly so as to provide more service places in districts with greater service demand.
On home care services, SWD has launched the Enhanced Home and Community Care Services specially for frail elders since April 2001. The former home help teams were then upgraded to Integrated Home Care Services teams. There are currently 24 Enhanced Home and Community Care Services teams and 60 Integrated Home Care Services teams, providing a total of 4,699 service places in the territory.
Whilst continuously expanding the existing services, we also adopt a new mindset to fully address the needs of elders. For example, we allocated funding of $96 million in 2008 for implementing the "Integrated Discharge Support Trial Programme for Elderly Patients". The programme targets the needs of elders newly discharged from hospitals and their family members, and provides intensive "one-stop" services for elders through the concerted efforts of healthcare professionals and home care services teams, with a view to facilitating elders' speedy recovery after discharge and helping them continue to age at home. In addition, we also allocated funding of $200 million in 2008 for launching the "Home Environment Improvement Scheme for the Elderly", providing home renovation services and household items for needy elders to reduce the risk of home accidents.
In the long run, the Government and the Elderly Commission will continue to explore ways to enhance the community care services for elders. The Commission is conducting an in-depth consultancy study on the issue and the study is expected to be completed early next year.
Ends/Wednesday, June 23, 2010
Issued at HKT 15:07
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