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LC: SHWF on budget debate


Following is the speech by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in response to the budget debate in the Legislative Council today (April 28)(English only):

Madam President,

I would like to begin by thanking Members for their valuable comments in respect of welfare and health issues. From Members' comments, it can be seen that social welfare is a matter close to your hearts, and it is also close to ours. Policies in respect of social welfare must be sustainable and underpinned by effective strategies and targetted programmes. In order to meet the objectives of the policies and assist the people it is intended to serve, these programmes must be evidenced based and must be evaluated to demonstrate effectiveness. As I explained to Members in this Council recently, our mission is to build a "Caring and Just Society", a society with rich diversity recognising the strengths of differently endowed individuals. Our strategies seek to enhance both individual and community capacities to deal with adversities and are implemented through an extensive range of services provided by both the Social Welfare Department and our Non-government organisation partners.

On the question of welfare expenditure, our investment in social welfare has increased by 23 per cent over the five years from 2000-01 to 2004-05. For direct services, i.e., discounting the provisions for the Comprehensive Social Security Assistance (CSSA) and other financial assistance, the increase is 14 per cent or $1.2 billion. For the financial year of 2004-05, the recurrent welfare provision amounts to $33.7 billion. Discounting provisions for social security, impact of civil service pay cut, lapsing of temporary jobs and one-off expenditure for SARS (Severe Acute Respiratory Syndrome) in 2003-04, there is still a net increase of $105 million in the 2004 Budget after deduction of efficiency savings, to cater for new and additional services mainly in elderly services and in rehabilitation and medical social services. Despite the overall stringent financial situation, there is still an increase in our investment in welfare services; and despite the need to seek efficiency savings, priority services would always be kept intact. That is why when we discussed this year's proposed efficiency savings with the welfare sector, we made it clear that we would be ready to provide assistance to subvented non-government agencies that encounter genuine difficulties in meeting the savings target. The Director of Social Welfare has been working closely with the sector in this regard.

Madam President, I have referred to the expression "investment in welfare services", because I believe this is how social welfare should be regarded. Effective social welfare programmes are not just about provision of welfare services. Effective social welfare programmes should be about investments in strategies and initiatives which yields results. Such programmes need to evolve and be recreated periodically to meet changing societal needs and should seek to build up social capital and enhance individual and community capacities to cope with changes and adversities. Active economic and social participation, social inclusion and self-reliance are some examples of investment returns. I have shared with Members this "social investment approach" not so long ago. I must say that I am very much encouraged that at a Conference held earlier this month to revisit our welfare philosophies, the majority of the over 400 attendees from the welfare and third sector reaffirmed that social welfare should take on a social investment instead of service provision perspective. We will continue to work closely with our NGO welfare partners to develop the concepts of social investment and social capital further. Separately, we are also discussing with both the welfare and business sector on how best to use the $200 million earmarked in the Budget to promote tripartite social partnership to encourage corporations to take part in helping the disadvantaged. We hope that the process in formulating a social investment strategy would help us identify and agree on renewed priority areas for action, set pointers on how to yield social returns and benefits to the individuals, and endorse the principles in relation to effective evaluation models. The business sector would definitely have a positive role to play in building up our community's capacities to deal with adversities. I look forward to working with our two partners to further develop sustainable strategies.

Many Members are concerned about the social problems in Hong Kong like poverty and domestic violence. Again, the Government share the same concern and sentiment. Poverty is a manifestation of adversities. It is a complex and multi-dimensional phenomenon and there is no simple panacea. Broad based economic growth is integral for providing opportunities for people in adversities to uplift their position; education, training and retraining are also essential in empowering them to capitalise on the opportunities available. In the context of social welfare, we seek to build up personal capacities to meet life's challenges, and to provide a safety net for those in need and render assistance to those who fall close to the net. It is incumbent upon us to ensure that a safety net is available to provide for the basic and essential needs of individuals and families who are in adversities. The CSSA scheme, which is non-cash limited, accounts for about 11 per cent of the recurrent expenditure of the Government this year, has been providing direct financial assistance to the needy. We also seek to ensure that the effective measures are in place to help able-bodied CSSA recipients or near recipients to become economically active again. In this connection, the Social Welfare Department will be conducting a study to evaluate the employment assistance programmes for CSSA recipients to identify ways to improve the effectiveness of these programmes.

Turning to family violence, this is something no society wishes to see or tolerate, in particular when the vulnerable and innocent children fall victim to such acts. All acts of violence should be seriously and harshly sanctioned. In the context of domestic violence, remedial action is not the solution: prevention is the key. We have put in place a continuum of preventive, supportive and specialised services designed to prevent family problems and to deal with them when they arise. There is however no ground for complacency. We are concerned about the problem and as part of our effort to map out evidenced-based strategies, the Director of Social Welfare commissioned last year, a study on child abuse and spouse battering. We look forward to receiving the experts' advice on the possible improvement measures. In the light of the tragedy in Tin Shui Wai, the Director of Social Welfare has initiated a review in the provision and service delivery process of family services in Tin Shui Wai, which will identify measures to strengthen the effectiveness, coordination and other aspects concerning service provision and delivery of family service in the area and to recommend any other general issues concerning the handling of family cases.

Madam President, a harmonious and violence free society is never an accident. While resources are essential to tackling social problems, they are only as good as the programmes so designed and the community it is intended to serve. A harmonious society is built on the concerted efforts of all in the community. As with many other social problems, family violence, in many instances, is a manifestation of how some individuals react in adversity and when under pressure. That is why from a broader perspective, it is crucial for us to ensure that our welfare services adopt a social investment approach to seek to build up individual and community capacities. This would ensure that both individuals and the community at large are better placed to face life's challenges.

In response to some Members' reference to health care financing, the financial sustainability of our health care system has long been a major concern for the Administration. In fact, we have on various occasions consulted this Council and the community on how best to address this issue, e.g., the Harvard Report in 1999 and the Health Care Reform Consultation Document in 2000. We have since introduced various strategic measures including (i) containment of costs and enhancement of productivity; (ii) improving the interface between the public and private health care sectors; (iii) revamp of public fees structure as a demand management tool; and (iv) initiating studies to assess the feasibility of establishing a Health Protection Account scheme to serve as a longer term health financing option.

On the containment of costs and enhancement of productivity, both the Hospital Authority and the Department of Health will continue to explore further opportunities for efficiency savings. We are also of the view that effective preventive programmes will improve the overall health status of the population as well as contribute towards cost-effectiveness in the longer run.

On improving the interface between the public and private health care sectors, we will continue to jointly explore with the Private Hospital Association and other private service providers on how the two sectors can collaborate to the benefits of the community. For example, to allow patients a greater choice of service between the two sectors, the Hospital Authority will make available to its patients more information relating to the private sector.

On the revamp of public fees structure, we have from November 2002 to April 2003 introduced a new fees structure for our public health care services. The revised structure has been effective in influencing public behaviour in the desired direction, e.g., since the introduction of the new fee, the utilisation rate of our Accident and Emergency services has decreased by over 10 per cent. It should be emphasised that the revamped fee structure has not affected the affordability of public health care services to the community. Recipients of CSSA continue to enjoy waivers for their medical expense. For vulnerable groups in the community who are not CSSA recipients, we have introduced in April 2003 an enhanced medical fee waiver mechanism to protect them from undue financial burdens arising from their medical expenses. Moreover, the maximum validity period of waiver certificates has been increased from six to 12 months.

Finally, on the proposal to establish a Health Protection Account (HPA) scheme in Hong Kong, a study group involving medical professionals, epidemiologists, actuaries, economists, statisticians and social scientists from the different universities, the Hospital Authority and Department of Health was formed to examine in greater depth the feasibility of applying the proposed HPA scheme as an additional source of health care funding in Hong Kong. Studies conducted by this group included existing pattern of health care services utilisation, projection of future health care utilisation, saving behaviours of our community, actuarial study of various HPA models, economic analysis of the impact of the HPA on savings and consumption, etc. This group is in the process of finalising its studies, and we plan to present the group's findings to this Council in mid-2004.

Thank you.

Ends/Wednesday, April 28, 2004


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