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Ageing Population
Present Situation
Extent of Population Ageing
53. Our population is rapidly ageing. As post-war "baby-boomers" approach retirement age, our population aged 65 or above is expected to surge from about 900 000 at present to 2.1 million by 2030 to account for a quarter of our population. The rapidly ageing population will bring tremendous challenges to our elderly and public healthcare services. We must get prepared.
Low Fertility Rate
54. Hong Kong's fertility rate has remained low in the past two decades. It dropped to an historic low of 0.9 in 2003. Despite a moderate rebound to 1.1 in 2010, it is still far below the replacement level of 2.1 children per woman.
Existing Policy and Challenges
55. Our population policy is to attract and nurture talent and improve the quality of our people to promote our development as a knowledge-based economy. It also seeks to achieve a balanced demographic structure to sustain Hong Kong's development. Given our ageing population and persistently low fertility rate, we can foresee that our workforce will shrink in just 10 years' time, which may threaten our sustainable development.
56. To encourage parenthood, this year's Budget increased the child allowance to alleviate the parents' burden in raising children.
57. To bring in talent, the Government has all along adopted an open immigration policy. In recent years, we put in place three talent admission schemes and streamlined the application procedures for employment visas. We also introduced relaxed measures to attract non-local students to work in Hong Kong after graduation. We will continue to enhance our talent admission arrangements.
58. Last year, I asked the Steering Committee on Population Policy to focus on two topics. First, ways to facilitate and support elderly people to settle in the Mainland after retirement if they so wished. Second, the ramifications of children born in Hong Kong to Mainland mothers returning to study and live in Hong Kong.
59. For our elderly people retiring in the Mainland, Members of the Steering Committee suggested the provision of better financial support and services in the Mainland.
60. In regard to Mainland women giving birth in Hong Kong, which has raised public concern, our basic principle is that Hong Kong residents receive priority for healthcare services. Therefore, the number of non-local women giving birth in Hong Kong must be capped to avoid overloading our healthcare services. Their Hong Kong-born children may choose to cross the boundary to attend school or to live in Hong Kong in future, which may strain our child care and education services. On the other hand, these children may replenish our ageing population. I must stress that the Government does not encourage Mainland women to give birth in Hong Kong. But as long as their children are Hong Kong permanent residents, we must consider these children as a valuable human resource for Hong Kong. In this regard, we must plan the relevant public services and make more realistic projections of the number of children who may come to settle or study in Hong Kong. The Committee will continue to co-ordinate these efforts.
61. For families with Hong Kong-born children living in the Mainland, we will step up the dissemination of information on the local education system to help them consider whether and how to arrange for their children to return to Hong Kong for schooling. For those students who cross the boundary to attend schools in the territory, we will put in place support measures at boundary control points to ensure their safe journey.
Specific Measures
Improving the Mode of Elderly Care
62. An ageing population leads to increasing demand for welfare and healthcare services. Apart from providing adequate resources for service expansion, we will improve the mode of elderly care to provide appropriate support.
Long-Term Care Services
63. An Elderly Commission study has found that resources allocated to community care services are far less than those allocated to residential care services. To rectify this situation, apart from increasing community care places, we should improve the content, form and funding mode of community care services to offer a desirable alternative to residential care.
64. Last year we announced a new initiative that enabled elderly people on the waiting list for nursing home places to try out tailor-made home care services. In this year's Budget, we extended the coverage of the Community Living Supplement under the Comprehensive Social Security Assistance (CSSA) Scheme to include recipients aged 60 or above who were ageing at home.
65. Next, we will consider community care vouchers to provide a direct subsidy for elderly people who need long-term care to acquire a wide range of services, and encourage diversity in service delivery agents. In parallel, we will provide more places for existing community care services.
66. Residential care services in Hong Kong are relatively developed, with 20% of our residential care places provided by subvented and contract homes and the remaining 80% by private and self-financing homes. In recent years, the vacancy rate of private homes has remained at about 30%. These private homes still have considerable capacity to cope with service demand.
67. The waiting time for subsidised places is long, not only because there is an actual shortage of nursing home places providing a higher level of care, but also because of the personal preferences of the applicants. Take the care and attention home places of a lower care level as an example. At present, 99% of elderly people on the waiting list have specified their district of choice. Since it takes time to satisfy their choices, the average waiting time is 22 months. If there is no location preference, an elderly person can get a place right away.
68. Currently, applicants for subsidised residential care places are not required to pass a means test. They only need to be assessed to confirm their needs for long-term care. In order to better allocate public resources to help those who most need residential care, we have to make best use of the care and attention home places provided by the private sector. At the same time, we need to focus our resources on the nursing home places that the private sector finds difficult to operate.
69. The Government has for years been buying residential care places from private homes under the Enhanced Bought Place Scheme. About a quarter of existing private homes have joined the Scheme. We will provide additional resources to encourage private homes to upgrade their services so that more elderly people on the waiting list will opt for them. We will also buy more places to help relieve the pressure on subvented and contract homes.
70. As for nursing home places, the Government has pooled resources to increase their supply in recent years. We have earmarked sufficient funds to increase the number of such places by more than 50% by 2015. Also, we will increase the supply of long-term care places providing a continuum of care. I must stress that, while we encourage the elderly to age at home, under no circumstances will we neglect their needs for residential care services.
71. In addition, as many elderly people choose to live in non-subsidised homes, I propose to introduce a supplement for CSSA recipients aged 60 or above living in such homes to ease their financial burden. CSSA recipients with disabilities of any age living in such homes may also receive the supplement.
72. The Government now grants a supplement to subsidised residential care homes for the elderly so that additional healthcare professionals can be employed to provide targeted training and care for residents suffering from dementia. The measure was extended to cover day care centres for the elderly last year. I propose to increase the amount of the supplement to enable such institutions to enhance support for demented elderly people.
Supporting Measures
73. We understand that elderly care is not just about funding. We need to tackle the shortage of land and manpower. Apart from reserving space for welfare service units in new development and redevelopment projects, we will actively identify designated sites for residential care homes. We will also take into account the requirements of the social welfare sector in the overall manpower planning of medical and healthcare professionals.
Strengthening Healthcare Services
74. To cope with demographic changes and the needs of elderly people, the Government will allocate additional funds to enhance public healthcare services such as cataract removal, haemodialysis, joint replacement and mental health services. Strengthening primary care services aside, we will improve long-term care services for frail elderly people.
Concessions for the Elderly
Concessions for the Use of Recreational Facilities
75. Swimming is a popular sport among the elderly and other age groups. We will introduce a Public Swimming Pool Monthly Ticket Scheme to lighten the burden of frequent elderly swimmers and promote swimming among the public.
Public Transport Concessions for the Elderly and People with Disabilities
76. Various concessionary fare schemes are currently implemented by major public transport operators for the elderly and people with disabilities. Concessions offered by individual operators vary. I propose to enable elderly people aged 65 or above and eligible people with disabilities to travel on the general MTR lines, franchised buses and ferries anytime at a concessionary fare of $2 a trip. For the revenue forgone, the Government will periodically reimburse the public transport operators on an accountable basis. We will request the operators to continue to absorb the cost of the existing concessions that they voluntarily offer to the elderly and people with disabilities.
Retirement Protection
Universal Retirement Protection
77. It is not easy for the community to reach a consensus on a universal retirement protection scheme. We have just implemented the minimum wage, and are studying the voluntary Health Protection Scheme and ways to enhance the Mandatory Provident Fund (MPF) schemes. Currently, low-income workers enjoy a certain degree of retirement and basic livelihood protection. It is impractical to introduce fundamental changes to the existing system and adopt a resource reallocation approach to deal with retirement protection because the middle class and professionals would generally not accept it now. It is more constructive to enhance the existing retirement protection system. The Government is studying this in depth.
MPF Review
78. Since the implementation of the MPF system, almost 85% of Hong Kong's workforce has been covered by some form of retirement protection. The MPF system has an average annual rate of return of 5.1% after fees and charges. As it is still at an initial stage, the MPF system requires continuous improvement.
79. The Government and the Mandatory Provident Fund Schemes Authority (MPFA) will strive to promote market competition. We will strengthen employees' right of choice to reduce the fees and charges of MPF schemes. The MPFA is studying supporting measures to facilitate the implementation of a full portability arrangement in the future. It will also look into whether the withdrawal of MPF accrued benefits in phases after retirement and early withdrawal under specific circumstances by employees should be allowed.
Guangdong Scheme
80. We will introduce a new "Guangdong Scheme" under the Social Security Allowance Scheme to provide an old age allowance for eligible Hong Kong elderly people who choose to reside in Guangdong. The rate will be the same as that for the local Old Age Allowance (OAA) in Hong Kong. Upon approval, recipients will be able to receive a full-year allowance in Guangdong without the need to come back to Hong Kong. The Labour and Welfare Bureau will shortly announce the key features. The Guangdong Scheme is based on four special considerations. First, currently Hong Kong elderly people settled in the Mainland mostly live in Guangdong. Second, there are especially close ties between Guangdong and Hong Kong in many aspects. Third, given the policies under the Hong Kong/Guangdong Co-operation Framework and with the completion of a number of major transport infrastructure projects, the two places will become more closely integrated and travel will be more convenient. Lastly, local elderly people who have moved to Guangdong can still maintain close contact with their relatives and friends here and obtain family support easily.
Medical Support in the Mainland
81. Apart from financial means and living environment, access to medical services is another consideration for senior citizens when deciding whether to settle in the Mainland. The liberalisation measures for the medical sector under the Mainland and Hong Kong Closer Economic Partnership Arrangement (CEPA) allow Hong Kong medical practitioners to practise or set up clinics or hospitals in the Mainland. In this way, senior citizens residing there may also receive Hong Kong-style medical services. The first hospital jointly established by the University of Hong Kong and the Shenzhen authorities will come into operation early next year. We will continue to strengthen co-operation between hospitals in Hong Kong and the Mainland, and negotiate with the Mainland measures to streamline the formalities for setting up clinics and hospitals there. We will also explore with Guangdong the cross-boundary patient conveyance arrangements to make it more convenient for Hong Kong patients residing in the Mainland to return to Hong Kong for medical treatment.
(To be continued)
Ends/Wednesday, October 12, 2011
Issued at HKT 11:54
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