LCQ8: Scope of the Elderly Health Care Voucher Pilot Reward Scheme
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Question:
The Government launched the Elderly Health Care Voucher Pilot Reward Scheme in 2023 to encourage eligible Hong Kong elderly persons aged 65 or above to use Health Care Vouchers for designated primary healthcare (PHC) services such as health assessment, chronic disease screening and management provided by private healthcare service providers. The Voucher amount spent can be accumulated for earning reward, which can be used for settling fees for such designated PHC services in future. The designated PHC services cover relevant services provided by medical practitioners, Chinese medicine practitioners and dentists enrolled in the Elderly Health Care Voucher Scheme; relevant services provided under the Chronic Disease Co-care Scheme; and relevant services under designated programmes of District Health Centres (DHC)/DHC Expresses. In this connection, will the Government inform this Council:
(1) whether doctors' medical treatment of chronic low back pain for elderly persons falls within the scope of chronic disease management under the designated PHC services;
(2) whether stroke rehabilitation treatment and thigh muscle (quadriceps) training conducted by physiotherapists (PTs) for elderly persons to delay osteoarthritis of the knee and alleviate pain constitute "services on preventive and follow-up/monitoring of long-term conditions"; if elderly persons receive the aforementioned physiotherapy services at DHCs, whether such services fall within the scope of the designated PHC services;
(3) with the emergence of first-contact PT services, whether rehabilitation treatment services provided by PTs and occupational therapists in the community, residential care homes for the elderly or residential care homes for persons with disabilities should be included in the designated PHC services; if so, of the timetable; if not, the reasons for that;
(4) whether the services provided by chiropractors in treating chronic low back pain for elderly persons, which include providing training and correcting sitting, standing and walking postures to reduce pain and thereby delay joint degeneration, accord with the principle of "follow-up/monitoring of long-term conditions"; whether the Government will include such services in the scope of the designated PHC services; if so, of the timetable; if not, the reasons for that; and
(5) whether services provided by optometrists for members of the public, such as optometric check-ups, screening for eye diseases, myopia control using defocus lenses, and visual rehabilitation, also accord with the principle of "preventive and follow-up/monitoring of long-term condition", and whether the Government will include such services in the scope of the designated PHC services; if so, of the timetable; if not, the reasons for that?
Reply:
President,
In consultation with the Department of Health and the Primary Healthcare Commission (PHC Commission), the consolidated reply to the various parts of the question raised by Dr the Hon David Lam is as follows:
The Government launched the Elderly Health Care Voucher Scheme (EHVS) in 2009 which aims at providing financial incentives, through offering partial subsidies, for elderly persons to choose private primary healthcare services that best suit their health needs. At present, 14 categories of registered healthcare professionals in Hong Kong are eligible to participate in the EHVS. They include medical practitioners, Chinese medicine practitioners, dentists, nurses, physiotherapists, occupational therapists, radiographers, medical laboratory technologists, chiropractors, and optometrists in Part I of the register under the Allied Health Professions Ordinance (Cap. 359); as well as audiologists, dietitians, clinical psychologists and speech therapists under the Accredited Registers Scheme for Healthcare Professions.
In accordance with the Primary Healthcare Blueprint (the Blueprint), the Government is progressively shifting the use of vouchers towards preventive care and chronic disease management. As such, the Government launched the three-year Elderly Health Care Voucher Pilot Reward Scheme (Pilot Reward Scheme) in 2023, and announced in February this year the extension of the Pilot Reward Scheme for two years to 2028. Under the Pilot Reward Scheme, eligible elderly persons accumulating voucher spending of $1,000 or above on designated primary healthcare services within the same calendar year (i.e. from January to December) will be allotted a $500 reward to their voucher accounts for use on the same purposes.
At present, the aforementioned designated primary healthcare services include services provided by medical practitioners or Chinese medicine practitioners enrolled in the EHVS, such as health assessment, body check, screening, vaccination, prescription of preventive medications and management of chronic diseases, and services provided by dentists, such as dental examination, scaling, extraction and filling. The purposes of these services are directly related to disease prevention or follow-up/monitoring of chronic conditions. After providing the service, healthcare professionals are required to record the reason for the elderly person's visit based on their professional clinical judgement, including whether it falls within the designated primary healthcare services under the Pilot Reward Scheme. Generally speaking, management of chronic low back pain by medical practitioners and Chinese medicine practitioners for elderly persons falls under the "follow-up/monitoring of chronic conditions" category of designated primary healthcare services.
The Government's long-term policy direction, in line with the Blueprint, is to empower the PHC Commission to define the service scope, standards and protocols of primary healthcare services (including preventive care), so as to ensure service quality and continuity. Accordingly, the scope of designated primary healthcare services under the Pilot Reward Scheme should align with the direction set by the PHC Commission, and should emphasise on guiding elderly persons to make good use of continuous, co-ordinated, and district-based services, rather than subsidising fragmented, one-off or episodic consultations provided by individual healthcare professionals. This also echoes the Blueprint's promotion of a family doctor-centric community healthcare system. District Health Centres (DHCs) and DHC Expresses (collectively referred to as DHCs) are strengthening their roles as community primary healthcare hubs, co-ordinating services provided by multi-disciplinary primary healthcare teams, while also serving as the entry point for screening and management services under the Chronic Disease Co-Care Scheme (CDCC Scheme). As long as the personalised services are co-ordinated through DHCs, they are included within the scope of designated primary healthcare services. These include, for example, chronic disease management programmes for knee pain and low back pain and post-stroke community rehabilitation programmes provided by physiotherapists or occupational therapists, as well as allied health services under the CDCC Scheme, including complication (e.g. diabetic retinopathy) monitoring services provided by optometrists, and musculoskeletal rehabilitation training and treatment services provided by physiotherapists. Elderly persons using the above services can benefit from the Pilot Reward Scheme.
Apart from services co-ordinated by DHCs or under the CDCC Scheme mentioned above, elderly persons may use health care vouchers to pay for services delivered independently by healthcare professionals such as physiotherapists, optometrists or chiropractors who have enrolled in the EHVS. As these services do not fall within the scope of designated primary healthcare services, the relevant amounts cannot be accumulated for reward redemption.
The Government will continue to monitor the implementation of the Pilot Reward Scheme and, in tandem with the ongoing development of the Primary Healthcare Co-care Network launched in March this year, review the scope of the Pilot Reward Scheme in a timely manner, with a view to providing elderly persons with primary healthcare services that best meet their needs while making optimal use of public resources.
Ends/Wednesday, June 24, 2026
Issued at HKT 15:00
Issued at HKT 15:00
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