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LCQ1: Elderly Health Care Voucher Scheme

     Following is a question by the Dr Hon Chiang Lai-wan and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 18):


     Under the current Elderly Health Care Voucher Scheme (EHCVS), the Government provides health care vouchers with a total value of $2,000 per person annually to eligible elderly persons aged 70 or above to subsidise their use of private primary care services.  The unused health care vouchers each year may be retained and used in future, subject to a cap of $4,000 on the cumulative value of the vouchers.  In this connection, will the Government inform this Council:

(1) as the information provided by the authorities to the Finance Committee of this Council in April this year indicated that in both of the past two years, the annual average values of health care vouchers used by an elderly person had exceeded $2,000, with a significant increase in the value of last year as compared with that of the preceding year, whether the authorities will consider increasing the annual value of health care vouchers so as to ease the burden of medical expenses on the elderly; if they will, of the details; if not, the reasons for that;

(2) as I have learnt that quite a number of elderly persons need to purchase auxiliary medical equipment and buy medicines at pharmacies, but they may not use health care vouchers for such purposes, whether the authorities will consider relaxing the restrictions on the permitted uses of such vouchers; if they will, of the details; if not, the reasons for that; and

(3) as the population projections published by the Census and Statistics Department in September last year indicated that the percentage of elderly persons aged 65 and above in the population would rise sharply, i.e. from 15 per cent in 2014 to 23 per cent and 30 per cent in 2024 and 2034 respectively, whether the authorities will consider afresh lowering the minimum age requirement for EHCVS to 65 so that more elderly persons will benefit from it; if they will, of the details; if not, the reasons for that?



     The Government launched the Elderly Health Care Voucher (EHV) Pilot Scheme in 2009 to subsidise Hong Kong elders aged 70 or above to use private primary care services, including preventive care services.  The scheme was converted from a pilot project into a recurrent programme in 2014.  Since the implementation of the EHV Scheme, we have introduced various enhancement measures to give elders a greater flexibility in using the vouchers for private primary care services.  For example, the annual voucher amount for an eligible elder has increased progressively from the initial sum of $250 to $2,000, and the financial cap has been revised upward from $3,000 to $4,000.  Moreover, the face value of each voucher was changed from $50 to $1 in 2014 to make it more convenient for the elders to use the vouchers.   As at end-March 2016, about 5 300 healthcare service providers are enrolled under the Scheme and over 610 000 elders have made use of the vouchers (accounting for about 80 per cent of the eligible elderly population).

     My reply to the various parts of the question is as follows:

(1) and (3) We have made a reply on the EHV Scheme (Reply Serial No. FHB(H)120) to the Finance Committee during its examination of Estimates of Expenditure 2016-17.  The figures in the reply show the average amount of vouchers used per elder among those who have made use of the vouchers, with breakdown by age group, during the period from the launching of the Scheme in 2009 up to end-2014 and end-2015.  

     Analysed by year among those elders who have made use of the vouchers, the average amount of vouchers used by an elder in 2014 and 2015 was $1,260 and $1,711 respectively.  Most of them (about 85 per cent and 67 per cent respectively) used an amount of $2,000 or less during these two years.  
     As regards the requests for lowering the eligible age for using the vouchers to 65 and increasing the annual voucher amount for an eligible elder, according to the Hong Kong Population Projections 2015-2064 published by the Census and Statistics Department, there will be 0.93 million elders aged 70 or above in 2020, which is 1.5 times as much as the existing number of elders using the vouchers, whilst the projected number of elders aged 65 or above is estimated to reach 1.4 million in 2020, which is about twice the number of elders using the vouchers at present.  With an ageing population, we anticipate that both the number of elders using the vouchers and the annual financial commitment involved will continue to increase substantially if there is an increase in the annual voucher amount or the eligible age is lowered to 65.  Hence, in considering the said requests, we need to examine the effectiveness of subsidising primary care services in the form of health care vouchers and assess in detail the long-term financial implications for the Government.  

(2) Under the existing EHV Scheme, vouchers cannot be used solely for purchasing medications or other medical equipment or products.  However, vouchers can be used for preventive, curative and rehabilitative services, including the treatments provided by healthcare service providers in their professional capacities to meet the healthcare needs of the elderly patients after consultation, as well as the medication and medical products etc. provided to the patients during the course of treatment.  In this regard, healthcare service providers should assume professional responsibility towards their patients.  Such arrangements serve to protect patients' rights while allowing a certain extent of flexibility to facilitate elders to use vouchers for paying various private primary care services.

     Besides, the Department of Health is currently conducting a comprehensive review of the EHV Scheme in collaboration with the Chinese University of Hong Kong's Jockey Club School of Public Health and Primary Care.  Opinions of elders and service providers on the Scheme, including its operational arrangements will be collected during the review.  We will closely monitor the pattern of using the vouchers and actively consider enhancing the Scheme as appropriate taking into account the review findings and the Government's fiscal condition.

     Thank you, Mr President.

Ends/Wednesday, May 18, 2016
Issued at HKT 12:41


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