LCQ2: Persons emigrated overseas returning to Hong Kong for welfare benefits and services

     Following is a question by the Hon Edward Leung and a reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (January 8):
 
Question:
 
     It is learnt that persons who have emigrated overseas can return to Hong Kong to enjoy some of the local welfare benefits, such as medical treatment, as long as they hold a valid Hong Kong identity card. There are views that such a practice will incur additional and unnecessary public expenditure and is not in the best interests of the local community. In this connection, will the Government inform this Council:
 
(1) whether it has compiled statistics respectively on data relating to returning to Hong Kong for medical treatment and the additional public expenditure involved in the past three years;
 
(2) whether it will commence a study on the situation of returning to Hong Kong for medical treatment, so as to conduct a systematic analysis of and formulate response plans for the relevant phenomenon, e.g. restricting the use of subsidised public healthcare services by persons who have emigrated overseas; if so, of the details; if not, the reasons for that; and
 
(3) given that at present only some welfare policies (e.g. Old Age Living Allowance) are subject to a limit of absence from Hong Kong, whether the authorities have considered, from the perspective of policy consistency, likewise imposing a limit of absence from Hong Kong on all welfare policies and subsidised public services, so as to prevent persons who have emigrated overseas from continuing to enjoy such welfare benefits and services; if so, of the details; if not, the reasons for that?
 
Reply:
 
President,
 
     In consultation with the Labour and Welfare Bureau and the Hospital Authority (HA), the reply to the question raised by the Hon Edward Leung is as follows:
 
     Hong Kong is a pluralistic and open society. As an international city with the highest degree of globalisation in the country, Hong Kong enjoys close co-operation and exchanges with the Mainland and the rest of the world, bringing together talents of different backgrounds and nationalities in search of economic and study opportunities and more with free multi-directional mobility, thereby enhancing Hong Kong's competitiveness. To capitalise on Hong Kong's unique advantages and high mobility of the local population, the Government needs to take into account a number of complex factors in formulating social welfare measures and various public services, in conjunction with the nature and objectives of relevant services, demand patterns, demographic structure, cost-effectiveness and social equity, etc. As such, the modes of operation for different social welfare measures and public services, including the service scope, eligibility criteria and level of subsidy, may also vary so as to cater to different needs of the public. How to define the statuses of ordinarily residing in Hong Kong, emigrating overseas or returning to Hong Kong for residence so as to adjust or even restrict holders of valid Hong Kong Identity Card from enjoying local welfare and utilising public services is a complex issue that requires extensive discussion before a consensus can be reached.
 
     Hong Kong has a dual-track healthcare system with both public and private sectors. Public healthcare services are the cornerstone and public safety net of Hong Kong's healthcare system. As the core of the public service system, the HA provides healthcare services that are heavily subsided by the Government, with the current subsidy at over 97 per cent on average. Nearly 90 per cent of the Hong Kong's population relies on the services provided by the public healthcare system. Nevertheless, Hong Kong's recurrent expenditure on public healthcare only accounts for about 3.9 per cent of the Gross Domestic Product, and such percentage is relatively low among other developed economies with a similar demographic structure. In terms of efficiency, with an annual government subvention of some $90 billion, the HA is able to serve nearly 90 per cent majority of some 7.5 million people in Hong Kong and establish a healthcare safety net. This has made Hong Kong's healthcare system renowned for its high efficiency among medical and healthcare services in the world.

     As a major public healthcare service provider, the HA is committed to meeting the policy objectives of the Government, including ensuring that no eligible citizen is denied of appropriate healthcare services due to financial difficulty. The HA manages a total of 43 public hospitals and medical institutions as well as 49 Specialist Out-patient Clinics, offering services by seven hospital clusters to provide citizens with comprehensive secondary and tertiary healthcare services. Meanwhile, the HA also manages 74 General Out-patient Clinics, providing community-based primary healthcare services. In order to optimise the use of resources while enhancing the healthcare efficacy for the public, the HA, when conducting service planning, prioritises its services based on four priority areas, namely (1) acute and emergency care services; (2) diseases requiring advanced technology, multi-disciplinary collaboration and high medical costs for treatment; (3) services for low-income persons and disadvantaged groups; and (4) training of healthcare professionals.
 
     Any holder of a valid Hong Kong Identity Card and any child under 11 years of age who is a Hong Kong resident is regarded as an Eligible Person for subsidised public healthcare services. At present, there is no requirement for the users to reside in Hong Kong for a specified number of days. Therefore, the HA does not require patients who seek services at the HA to provide information on the number of days they have resided in or left Hong Kong when attending each consultation, hence cannot compile statistics relating to the so called "emigrants returning for medical treatment". In view of the sporadicity and urgency of healthcare services that make it impossible for approval of applications annually, the HA currently has no intention to require all holders of valid Hong Kong Identity Card to provide information on the number of days they have resided in Hong Kong for each medical consultation, and identify them as "emigrants returning for medical treatment" in a bid to restrict their use of the services.
 
     On social welfare, the Government puts in place requirements on age, means tests and permissible limits of absence from Hong Kong, etc, for different subsidised public services based on the different policy objectives and needs of recipient groups.
 
     As regards cash assistance, the Comprehensive Social Security Assistance (CSSA) Scheme and the Social Security Allowance (SSA) Scheme (including Old Age Allowance, Old Age Living Allowance and Disability Allowance) impose permissible limits of absence from Hong Kong before application and during receipt of payment, so as to ensure that recipients have close connections with Hong Kong.
 
     Before application, CSSA applicants must have been a Hong Kong resident for not less than one year, and must have resided in Hong Kong for at least one year since acquiring Hong Kong resident status. The one-year residence needs not be continuous or immediately before the date of application, with a 56-day absence limit. During receipt of payment, elderly persons or disabled recipients enjoy a limit of 180 days of absence from Hong Kong in a payment year, whereas other categories of recipients will enjoy a limit of 60 days of absence from Hong Kong in a payment year. Where a recipient resides in Hong Kong for less than the specified number of days in a payment year, i.e. 365 days less the permissible absence limit, his/her CSSA entitlement will be pro-rated on the basis of the number of days of residence in Hong Kong plus the permissible absence limit.

     SSA applicants must have resided in Hong Kong continuously for at least one year immediately before the date of application, with a limit of 90 days of absence from Hong Kong. During receipt of payment in Hong Kong, if a recipient resides in Hong Kong for not less than 60 days in a payment year, he/she is entitled to a full-year allowance. If he/she resides in Hong Kong for less than 60 days, he/she is only entitled to an allowance for the period of residence in Hong Kong.
 
     Users of social welfare services of the Social Welfare Department or subvented organisations generally receive the relevant services in Hong Kong. If service users do not receive service for a long period due to absence from Hong Kong, they will be required to withdraw from the relevant services.
 
     The Government will continue to keep in view social changes and review the provision of the existing social welfare measures and public services from time to time.