20 September 2019
The government will build integrated elderly care centers that can provide senior citizens with one-stop and multi-disciplinary care as well as social welfare services. Photo: HK Govt
The government will build integrated elderly care centers that can provide senior citizens with one-stop and multi-disciplinary care as well as social welfare services. Photo: HK Govt

Responding to elderly care initiatives in policy address

As far as elderly care services are concerned, I agree with the main direction laid down in the recent policy address, under which the government pledged to enhance both home care and community care services for our senior citizens.

And I was also glad to learn that the administration has responded positively to some of the suggestions put forward by the local healthcare sector on the issue.

For example, the chief executive has vowed to provide an additional 1,000 vouchers under the second phase of the Pilot Scheme on Community Care Service Voucher for the Elderly, so that the total number of vouchers available will reach 6,000 by next year. As the CE put it in the policy address, the government is working aggressively to achieve “zero waiting time” for voucher applicants.

However, some in the healthcare sector have pointed out that even if the government is able to deliver its promise of increasing the number of elderly care service vouchers to 6,000, it can still hardly reduce the waiting time of applicants to zero, since currently there are more than 9,000 senior citizens on the waiting list for these vouchers.

Besides, increasing the number of these vouchers has to go hand in hand with boosting the variety and quality of the service itself in order to ensure that the community care service voucher scheme for the elderly can live up to public expectations.

As such, I strongly urge the government to devise measures to guarantee that there is sufficient manpower to deliver the service. Otherwise, achieving zero waiting time would be an empty slogan.

On the other hand, I also welcome the proposed government initiative to launch a pilot scheme under which the administration will build integrated elderly care centers in the community, which will provide our senior citizens with one-stop and multi-disciplinary care as well as social welfare services.

At present, there are already quite a few elderly care services available at the community level, but these services are often too dispersed, poorly coordinated and overlapping with one another.

By setting up integrated elderly care centers that provide one-stop services in disease prevention, transitional care and rehabilitation for the elderly, I hope the government can redress the currently chaotic situation as far as community care services for the elderly are concerned, so that in the future our seniors can be spared the trouble of visiting multiple healthcare outlets for different services.

In the meantime, the policy address has also proposed to launch a four-year pilot program under which the government will put together a district-based and multi-disciplinary team that includes social workers, physiotherapists and occupational therapists etc. to provide outreach services for residents of private nursing homes and residential care homes for the disabled in order to meet their social and rehabilitation needs more flexibly.

The policy address also proposed to provide visiting doctor services for residents of these private institutions as a precautionary measure to guard our elderly against seasonal flu and other episodic medical conditions, thereby reducing their chances of repeated hospital admissions.

While I welcome these initiatives, I also suggest that the proposed multi-disciplinary outreach team include registered nurses, pharmacists, hearing therapists and speech-language pathologists.

In the meantime, I also urge the administration to consider extending the proposed outreach services to elderly people living at home as well and to subject the scheme to constant review.

However, while I believe we should give our Chief Executive some credit for launching these elderly care initiatives, I must also say that I am indeed rather disappointed by the failure of the policy address to address the fundamental issue of raising the service quality of private nursing homes.

Despite the fact that the Chief Executive has come up with a number of plans in her policy address in an attempt to raise the overall quality of service of private nursing homes, these initiatives are apparently unable to get to the root of the issue.

The only way to address the issue of poor management of private nursing homes and raise the overall quality of service is to amend the existing Residential Care Homes (Elderly Persons) Ordinance so as to tighten regulation of different aspects of the operations of private nursing homes such as their human resources planning and guidelines on care procedures.

Unfortunately, the policy address did not put forward any proposal in this regard. All it did is vow to keep on reviewing the existing laws that govern private nursing homes, which I believe is far from enough.

Also disappointing is the fact that our Chief Executive has failed to address grave concerns among the healthcare sector over the controversial one-off subsidy program for private nursing homes, which has, to a significant extent, resulted in their inability to hire professional medical staff due to insufficient resources.

Nor did the policy address answer our calls for enhancing hearing therapy and dental care services for the elderly, as well as increasing the number of speech-language pathologists in our public hospitals, as more and more elderly people in Hong Kong are suffering from dysphagia and speech impairment.

Last but not least, the government has remained sluggish in promoting hospice and palliative care services, and the policy address did not address this issue either.

That said, I sincerely hope that the government can formulate a comprehensive policy and legal framework on hospice care for the terminally ill in a more proactive manner.

This article appeared in the Hong Kong Economic Journal on Oct 25

Translation by Alan Lee

[Chinese version 中文版]

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Legislative councilor and head of nursing and health studies in the Open University of Hong Kong