LCQ8: Services for the elderly

     Following is a question by the Hon Leung Yiu-chung and a written reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (December 4):

Question:

     For those elderly persons who have been confirmed after assessment to have the needs for long term care services, their applications may be put on a Central Waiting List for Subsidised Long Term Care Services (CWL) to wait for provision of subsidised long term care services, i.e. residential care services (RCS) or community care services (CCS). In this connection, will the Government inform this Council:
 
(1) of (i) the number of elderly persons who requested their names be removed from CWL and the reasons for that, and (ii) the number of elderly persons who had been allocated a place in a residential care home (RCH) but eventually declined the offer and the reasons for that, in each of the past five years; among such elderly persons, the number of those who were assessed to be suitable for receiving RCS only;
 
(2) as it is learnt that those elderly persons on CWL who are soon to be placed to a RCH will be included in the small pools list, of the following details in each of the past five years:
(i) the average time span from the elderly persons being included in the small pools list to being allocated a RCH place;
(ii) among the elderly persons on the small pools list, the number and percentage of those who had been allocated a RCH place but eventually declined the offer, and the reasons for that; and
(iii) among the elderly persons who had waited for RCS, the number and percentage of those who declined to be included in the small pools list;
 
(3) of the average (i) monthly and (ii) full-year numbers of vacant places and the vacancy rates in the total number of subsidised RCH places in Hong Kong in each of the past five years; the average (iii) monthly and (iv) full-year numbers of vacant places and the vacancy rates of those RCHs preferred by the elderly persons on the small pools list, in each of the past five years;
 
(4) of the number, in each month of the past two years, of the elderly persons on CWL who had been assessed to be suitable for both RCS and CCS; among these elderly persons, (i) the number of those "inactive" cases in which the elderly persons chose to receive CCS, and (ii) the number of cases in which the elderly persons had initially chosen to wait for RCS but subsequently received CCS;
 
(5) among the elderly persons on CWL, of the respective numbers and percentages, in each month of the past two years, of those elderly persons who, after assessment, were arranged to wait for (i) RCS only and (ii) CCS only;
 
(6) given that the Government reinstated in October last year the population-based planning ratios for elderly services facilities in the Hong Kong Planning Standards and Guidelines, of (i) the number of places for the two aforesaid types of services that should be provided according to the calculation based on such ratios, and (ii) the actual number of places available for these two types of services, in each District Council district at present, as well as the details of the calculation methods; when the Government will review such ratios; and
 
(7) whether the Government, when planning the elderly service places on a territory-wide basis, has included the service quotas under the Pilot Scheme on Community Care Service Voucher for the Elderly and under the Pilot Scheme on Residential Care Service Voucher for the Elderly?

Reply:
 
President,
 
     My reply to the Member's question is as follows:
 
(1) and (2) From 2014 to 2018, amongst the applicants on the Central Waiting List (CWL) for subsidised residential care places for the elderly, the numbers of applicants withdrawing their applications, rejecting offers of placement, and being assessed to be suitable for residential care services (RCS) only amongst those rejecting offers of placement are as follows –
 

 
     Applicants withdraw applications and reject offers of placement for various reasons, such as being in receipt of subsidised community care services (CCS), changing preferences for location and dietary requirements of residential care homes for the elderly (RCHEs), etc. The Social Welfare Department (SWD) does not maintain statistics on average waiting time between applicants' entry to the small pool and admission to RCHEs, applicants declining admission to RCHEs after entering the small pool and applicants refusing to enter the small pool.
 
(3) At present, the demand for subsidised residential care places for the elderly is acute. Whenever vacancies arise, the SWD will arrange admission by applicants on the CWL. The SWD does not maintain statistics on the duration of subsidised residential care places for the elderly remaining vacant.
 
(4) and (5) From 2017-18 to 2018-19, the number of applicants assessed to be suitable for both RCS and CCS, suitable for RCS only and suitable for CCS only in assessments conducted are as follows –
 

 
     For the applicants assessed to be suitable for both RCS and CCS, when they receive CCS, their applications for RCS will automatically be classified as "inactive". These applicants can seek to re-activate their RCS option if needed in future. Amongst the applicants assessed to be suitable for both RCS and CCS, the SWD does not maintain statistics on the number of RCS cases being classified as "inactive" upon receipt of CCS and those initially admitted to RCS but later accepted CCS.
 
(6) According to the Hong Kong Planning Standards and Guidelines updated in December 2018, the standard of RCS provision is 21.3 subsidised beds per 1 000 elderly persons aged 65 or above. The SWD plans RCS on a five-cluster basis (i.e. Hong Kong, Kowloon East, Kowloon West, New Territories East and New Territories West). The Hong Kong Planning Standards and Guidelines should be applied flexibly at the cluster level, with the SWD considering a number of factors, particularly the distribution of RCS in various districts within the cluster. Other factors to be considered include the land supply in different districts within the cluster, service demand as a result of population growth and demographic changes, as well as provision of different types of RCS in the clusters. As at October 2019, there are in total around 28 000 subsidised RCS places in the territory.
 
     For CCS, the planning standard is 17.2 subsidised places per 1 000 elderly persons aged 65 or above. The planning standard should be applied flexibly at the district level, with the SWD considering a number of factors, including the distribution of CCS, the land supply and service demand as a result of population growth and demographic changes. As at October 2019, there are in total around 13 700 service places for CCS in the territory.
 
(7) Adopting the "money-following-the-user" funding mode, the Pilot Scheme on Community Care Service Voucher (CCSV) for the Elderly and the Pilot Scheme on Residential Care Service Voucher (RCSV) for the Elderly provide additional choices for the elderly persons. Voucher users can select and switch recognised service providers according to their individual preferences. As the two schemes are still at the pilot stage, they are not included in the number of service places stated in the reply for Part 6 above. The Government has commissioned consultants to conduct evaluation studies on the two schemes, and will consider the way forward and long-term arrangements for the CCSV and RCSV with reference to the findings of the studies.