LCQ5: Community care services for the elderly

     Following is a question by the Hon Leung Yiu-chung and a reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (May 22):

Question:

     Community care services for the elderly include: "Integrated Home Care Services (Frail Cases)" and "Enhanced Home and Community Care Services" (EHCCS) which target at the frail elderly, as well as "Integrated Home Care Services (Ordinary Cases)" (Ordinary Case Services) which target at the elderly who have no or mild level of impairment. In December last year, the Government amended the Hong Kong Planning Standards and Guidelines (HKPSG) by reinstating population-based planning standards for elderly services and facilities, but such planning standards do not cover Ordinary Case Services. In this connection, will the Government inform this Council:

(1) Whether the amended HKPSG is applicable to those public housing development projects the planning of which was made before December last year; in respect of those public housing development projects for which elderly services and facilities were planned in accordance with the pre-amended HKPSG, of the measures put in place by the Government to alleviate the shortfalls in such services and facilities;

(2) As the aforesaid amendments to HKPSG do not cover Ordinary Case Services, whether the Government will set out in HKPSG a population-based planning standard for such services; if so, of the details; if not, the reasons for that; and

(3) As the Secretary for Labour and Welfare advised last month that the Government planned to restructure the scope of Integrated Home Care Services and EHCCS, as well as to provide the additional resources needed without increasing the number of service teams, of the details of the restructuring work (including the restructuring approach, implementation timetable, and whether this will also cover the Ordinary Case Services) and the provision of additional resources (including manpower, offices and kitchens)?

Reply:

President,

     I will give a consolidated reply to sub-questions 1 and 2 regarding the arrangements of the Hong Kong Planning Standards and Guidelines (HKPSG).

     The HKPSG stipulates general guidelines on the scale and location of various types of land use, community facilities and basic facilities. It will facilitate the Government in reserving land for the provision of appropriate and sufficient facilities during the planning process. The Government promulgated the amended HKPSG on December 28, 2018, which stipulates the population-based planning standards in respect of subsidised residential care services (RCS), subsidised community care services (CCS), District Elderly Community Centres (DECCs) and Neighbourhood Elderly Centres (NECs). This will assist government departments in reserving appropriate land for the provision of these elderly services and facilities in the planning process of residential development projects (including public housing).

     It is worth noting that the previous version of HKPSG, before the incorporation of the above amendments, had already stated that demographic characteristics, geographical environment, actual demand and supply of the services, etc. should be suitably considered during the planning of DECCs, NECs and Day Care Centres/Units for the Elderly. As regards subsidised RCS, the previous version of HKPSG also stipulated that demand and supply, resources, availability of suitable premises, etc. are factors that should be taken into account. Indeed, relevant departments have all along been reserving suitable premises in public housing development projects for elderly services and facilities.

     The Government will proactively implement the various planned elderly services and facilities. With reference to the amended HKPSG and the demand and supply of various services and facilities, the Government will continue to adopt a multi-pronged approach to increase supply. Among other things, the Social Welfare Department has earmarked sites in a number of development projects for the construction of welfare facilities required, including elderly service facilities, which are in acute demand. These development projects include public housing development projects, private land development projects, development projects of the Urban Renewal Authority, redevelopment/conversion projects of vacant school premises, development projects on "Government, Institution or Community" sites, etc. The Government will also incorporate land sale conditions for suitable land sale sites, requiring private developers to construct welfare facilities specified by the Government.

     The Ordinary Case Services mentioned in the Member's question should be referring to the Integrated Home Care Services (Ordinary Cases) (IHCS(OC)). This type of services provides community support services, such as household duties, escort, meal services, etc., to elderly persons with no impairment or mild impairment. According to the recommendation of the Elderly Services Programme Plan (ESPP), when stipulating population-based planning standards to meet the projected demand for long-term care (LTC) services, the planning standard in respect of CCS places should take into account the LTC services demand for elderly persons who are assessed to be in the state of moderate or severe level of impairment by the Standardised Care Need Assessment Mechanism for Elderly Services. Since IHCS(OC) is not a type of LTC services, the planning standard in respect of CCS places does not cover IHCS(OC).

     Regarding sub-question 3, as recommended in the ESPP, we should significantly strengthen community-based services in order to achieve "ageing-in-place" and reduce premature or long-term institutionalisation into residential care homes for the elderly. To support elderly persons who are living in the community but require care and support services, it is necessary for the Government to provide them with timely and comprehensive CCS. At present, the IHCS (Frail Cases) and the Enhanced Home and Community Care Services (EHCCS) specifically provide necessary home care services for elderly persons assessed to be in the state of moderate or severe level of impairment. While recommending that these CCS should be enhanced, the ESPP also suggested the Government to review these two types of services. On the premise that a degree of choice would be maintained for users, the funding modes and service arrangements for these two types of services should be reviewed in order to increase efficiency. We would follow up the recommendations of the ESPP at an appropriate juncture, with a view to strengthening the relevant community care and support.

     In addition, it was announced in the 2018 Policy Address that the Government would provide 2 000 extra service quotas under EHCCS within 2019.