Following is a question by Professor the Hon Chan Wing-kwong and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (April 1):

Question:

     There are views that quality end-of-life care services have become more important amid the continuing trend of population ageing in Hong Kong. In this connection, will the Government inform this Council:

(1) of the details of the medical and social welfare care services currently provided by the Government to terminally-ill patients and their families;

(2) whether it knows the respective numbers of attendances at the Hospital Authority's (HA) in-patient palliative care services, ambulatory palliative care services and palliative home care services in the past three years;

(3) whether the authorities have compiled statistics on the number of cases in which individuals chose to die at their place of residence (including residential care homes and private accommodation) in the past three years, and the details of the support measures (e.g. end-of-life care services) provided to the families in those cases by the authorities;

(4) of the respective numbers of advance medical directives and do-not-attempt cardiopulmonary resuscitation orders made/issued by HA in the past three years;

(5) as the Advance Decision on Life-sustaining Treatment Ordinance (the Ordinance) will come into effect in the middle of this year, of the latest progress of the authorities' preparatory work for implementing the Ordinance; and

(6) of the latest measures that the authorities have put in place to continuously optimise the care services for terminally-ill patients, and to enhance public awareness and understanding of topics such as life and death education?

Reply:

President,

     The Government's policy objective is to ensure patients and their families receive appropriate end-of-life (EoL) care services.  To this end, the Government is committed to promoting the development of palliative care services.  Currently, palliative care services in Hong Kong are primarily provided by the Hospital Authority (HA). Over the past decade, the HA has progressively expanded palliative care services to cover more patients, including those with advanced cancer and end-stage organ failure. To empower terminally ill patients with greater autonomy in their own treatment and care arrangements, the Government has enacted the Advance Decision on Life-sustaining Treatment Ordinance (the Ordinance), which establishes a corresponding legal framework for advance decision instruments (i.e. advance medical directives (AMDs) and do-not-attempt cardiopulmonary resuscitation (DNACPR) orders) and provides legal protection for healthcare professionals when complying with such directives and orders. The Ordinance is planned to take effect in the middle of this year, with the specific date to be announced in due course.

     The reply, in consultation with the Social Welfare Department (SWD) and the HA, to the questions raised by Professor the Hon Chan Wing-kwong is as follows: 

(1) Adhering to the principle of "providing holistic care for patients", the HA has been offering appropriate palliative care services to terminally ill patients and their families through a multidisciplinary team of professionals, including doctors, nurses, medical social workers, clinical psychologists, physiotherapists, and occupational therapists, under a comprehensive service model.  At present, the HA provides palliative care services to terminally ill patients across all seven clusters, covering inpatient, consultative, outpatient, palliative day‑care, home‑care and bereavement services etc. Since 2015-16 , the HA has also progressively enhanced the services of the Community Geriatric Assessment Teams (CGATs) to implement the EoL Care Programme in Residential Care Homes for the Elderly (RCHEs) which supports residents of RCHEs who are suffering from terminal illnesses. 

     In terms of social welfare support, the elderly community care and support services funded by the SWD, as well as the Community Care Service Voucher Scheme for the Elderly, provide EoL care services to elderly persons in need.  Multidisciplinary service teams comprising social workers, nurses, physiotherapists, and occupational therapists assess the needs of frail elderly and formulate individual care plans, including whether EoL care services are required. Furthermore, elderly centres will provide members with relevant counselling services and arrange service referrals, where appropriate.

(2) and (3) Considering that some terminally ill patients may wish to remain in familiar surroundings for care until their passing, the HA and the SWD currently offer appropriate support in accordance with patients' wishes and needs. For patients receiving care at home, palliative home care teams of the HA will formulate suitable care plans based on the patients' conditions and provide holistic physical, psychosocial and spiritual support, thereby ensuring they receive proper care at home. As for patients residing in RCHEs, the HA's CGATs collaborate with palliative care teams and RCHEs to implement the EoL Care Programme in RCHEs under which CGATs provide professional medical and nursing care to residents with terminal illnesses, while enhancing caregivers' competency in caring for terminally ill patients through training.  

     Over the past three years, demand for the HA's palliative home care services has recorded a year-on-year increase, with service attendances reaching approximately 54,000 in 2024-25.  The statistics on overall utilisation of the HA's palliative care services are shown in the table below (Note 2):
 

	2022-23 (Actual)	2023-24 (Actual)	2024-25 (Actual)
Palliative Care Inpatient Service (Note 1)  (Total number of inpatient and day inpatient discharges and deaths)	7 283	7 981	8 082
Palliative Care Specialist Outpatient Service (Note 1)   (Number of attendances)	12 951	14 235	13 977
Palliative Home Visits by Staff  (Number of attendances)	51 230	52 775	54 598
Palliative Day Care Service (Number of attendances)	7 944	12 879	14 223
Bereavement Service (Number of attendances)	8 054	7 573	7 578

     Support for dying-in-place is an integral component of EoL care.  For terminally ill patients who choose to pass away in their place of residence, we have been providing appropriate support. In terms of hardware, the SWD has been supporting RCHEs and residential care homes for persons with disabilities (RCHDs) in adopting various models to provide EoL care services.  Since September 2017, all newly established contract homes have been equipped with an EoL care room, allowing residents to face death with dignity and peace in a familiar environment. The SWD also encourages existing RCHEs and RCHDs to make flexible use of space to provide the relevant services. Regarding legislation, under the Coroners Ordinance (Cap. 504), deaths that meet specified conditions and occur at home are not required to be reported to the Coroner. To facilitate terminally ill patients residing in RCHDs and RCHEs that are not nursing homes in opting for dying-in-place arrangements, we amended the relevant provisions of the Coroners Ordinance and the Births and Deaths Registration Ordinance (Cap. 174) in June 2024 to provide that deaths complying with the statutory conditions are also exempt from the requirement of reporting to the Coroner. The Government has been collecting relevant information through various channels to keep track of service trends, including the on-going collection of service utilisation data related to EoL care through the CGATs.  Notably, the number of deaths in RCHEs participating in the Jockey Club End‑of‑Life Community Care Project (JCECC) (Note 3) was 27 between 2016 to June 2024. Following the implementation of the legislative amendments in June 2024, the figure rose to 75 by the end of 2025 (Note 4). Such increase demonstrates that, with the gradual enhancement of service support and the flexibility brought about by the legislation, there has been growth in the number of cases choosing to pass away in residential care homes, reflecting a steady increase in the acceptance of dying-in-place arrangements among terminally ill patients and their families. The Government will continue to collect relevant data for reference when reviewing the planning of EoL care services.

(4) The number of AMDs made within the HA from 2023 to 2025 is tabulated as follows:
 

Year	Number of AMDs
2023	1 567
2024	1 788
2025	2 070

     The number of DNACPR orders made within the HA from 2023 to 2025 is tabulated as follows:
 

Year	Number of DNACPR orders
2023	4 354
2024	4 876
2025	5 084

(5) and (6) To ensure the smooth implementation of the Ordinance in mid-2026, the Government has allocated an adequate preparation period following its passage to allow healthcare institutions, relevant departments, and organisations to make the necessary transitional arrangements. The latest progress of the relevant preparation work is summarised as follows:

     On formulating or updating guidelines, the Hong Kong Academy of Medicine has issued the "Best Practice Guidelines on Advance Medical Directives", which elucidates the application of the Ordinance and provides practical operational guidance to better equip doctors with the knowledge of the legislative requirements when formulating and implementing AMDs and DNACPR orders.  In addition, the HA has revised the "Guidelines on Life-Sustaining Treatment for Patients Approaching End of Life" in October 2025 for reference by healthcare staff. For RCHEs and RCHDs, the SWD has provided reference guidelines on EoL care services to residential care homes in May 2024, offering practical advice on implementing EoL care services (including formulating advance care plans and AMDs).

     On professional training, the Health Bureau (HHB) has co-ordinated with government departments and relevant rescue organisations involved in emergency rescue operations to brief frontline personnel on the legal framework of the Ordinance, ensuring that they understand the relevant provisions. Furthermore, the HA has provided relevant training to healthcare staff in all clusters to enhance their competency in handling advance decision instruments.

     Regarding transitional arrangements for AMDs and DNACPR orders, Advance Directives made before the commencement of the Ordinance will remain valid, provided that they meet the conditions stipulated in the Ordinance. In addition to the existing paper-based AMDs, electronic AMDs will be introduced in phases, using eHealth as the designated electronic system.  The HHB is working on updating the functions of eHealth and co-ordinating with relevant healthcare institutions and organisations to update their electronic systems to support the initial phase of storing AMDs in electronic form. Furthermore, to complement the implementation of the Ordinance, the HA has been progressively replacing the old DNACPR order forms with prescribed forms for patients starting from December 2025 to ensure that these orders will remain valid after the Ordinance comes into effect.

     As regards public education, the Government has been promoting public awareness of the Ordinance through cross-departmental and cross-sectoral public education and promotional initiatives. The HHB, in collaboration with the JCECC and social service organisations, co-organised multiple community seminars to introduce the Ordinance to the public. In addition, relevant government departments and public organisations have launched a series of life-and-death education promotional activities for specific groups to enhance public understanding of topics such as advance care planning, advance decision instruments, and EoL care.

     The HHB will continue to collaborate with the relevant government bureaux and departments, the HA, and various stakeholders to allocate resources appropriately in response to demographic changes and evolving service demand, thereby promoting the development of palliative care services. Concurrently, we will continue to deepen public education on the Ordinance as well as life‑and‑death issues to support the advancement of EoL care services.

Note 1: The above figures only include palliative care inpatient and outpatient services that are captured by the designated coding in the computer system.

Note 2: In view of the COVID-19 epidemic outbreak in Hong Kong in early 2020, the HA has adjusted its services to cope with the outbreak.  Therefore, the above situation should also be taken into account when comparing the HA's service volume across the relevant years.  With the subsiding of Hong Kong's COVID-19 epidemic situation and cessation of anti-epidemic measures in early 2023, the HA has been gradually resuming provision of all of its public healthcare services to tie in with the Government’s normalcy measures.

Note 3: The JCECC is an EoL care initiative launched by the Hong Kong Jockey Club Charities Trust in 2016.  Through collaboration between universities and various non-profit organisations, the project aims to enhance the quality of EoL care within communities and residential care homes. The project encompasses EoL support for RCHEs, caregiver training, and public education. Since August 2024, the project has been extended to cover terminally-ill persons with disabilities with the "JCECC: Unison" initiative introduced to support RCHDs in facilitating dying-in-place for their residents. 

Note 4: The figures provided above only cover the RCHEs participating in the JCECC Project and do not necessarily represent the total number of dying‑in‑place cases across all RCHEs in Hong Kong. Regarding RCHDs, as the "JCECC: Unison" initiative is in its initial implementation phase, the data is currently under consolidation.

Ends/Wednesday, April 1, 2026
Issued at HKT 16:40

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