LegCo Paper No CB(2)2383/96-97
(These minutes have been seen
by the Administration)
Ref : CB2/PL/WS

LegCo Panel on Welfare Services

Minutes of Meeting held on Friday, 14 March 1997 at 2:15 pm in the Legislative Council Chamber

Members Present:

Members Absent:

Member Attending:

Public Officers Attending:

Mr HO Wing-him: Deputy Secretary for Health and Welfare (Welfare)
Item III
Ms Miranda CHIU: Principal Assistant Secretary for Health and Welfare (Welfare)
Mrs Patricia CHU: Deputy Director of Social Welfare (Service)
Mrs Nancy TSE: Assistant Director of Social Welfare; (Family and Child Welfare)
Item IV
Mr Augustine CHOI: Commissioner for Rehabilitation
Mrs Eliza LEUNG: Assistant Director of Social Welfare (Rehabilitation)
Dr CHOY Khai-meng: Senior Manager (Professional Services)
Dr SHUM Ping-shiu: Hospital Chief Executive; Kwai Chung Hospital
Dr TANG Wai-nang: Chief of Service (Psychiatry); Pamela Youde Nethersole; Eastern Hospital
Item V
Ms Miranda CHIU: Principal Assistant Secretary for Health and Welfare (Welfare)
Mrs Patricia CHU: Deputy Director of Social Welfare (Services)
Mr LI Kok-ming: Chief Social Security Officer
Item VI
Ms Miranda CHIU: Principal Assistant Secretary for Health and Welfare (Welfare)
Dr K Y TANG: Government Economist
Mr Andrew LEUNG: Director of Social Welfare
Miss Lilian FUNG: Senior Statistician

Attendance by Invitation :

Ms Deborah WAN
Ms Kimmy HO
Mr Joseph CHAN
Ms Stella HO
Item V
Hong Kong Family Welfare Society
Mr Robert NIELD: Chairperson; Isolin Clague Trust Allocation Committee
Ms Cecilia KWAN: Assistant Director
Miss Ellennie HUI: Principal Social Worker

Clerk in Attendance:

Mrs Mary TANG: Chief Assistant Secretary (2)4

Staff in Attendance :

Miss Joanne MAK: Senior Assistant Secretary (2)4

I. Confirmation of minutes of meeting and matters arising

II.Items for discussion at the next meeting

III.Welfare services for new immigrants from China

IV.Rehabilitation and support services for ex-mental patients

V.A survey on the needs of single parent families

VI. Social Security Allowances : Revision of rates under CSSA and the Social Security Allowance (SSA) Schemes

I. Confirmation of minutes of meeting and matters arising

(LegCo Paper No. CB(2)1303/96-97)

The minutes of the meeting held on 10 January 1997 were confirmed.

2.Members indicated that they did not intend to conduct any overseas duty visits from April to June 1997.

II.Items for discussion at the next meeting

3.The following items were scheduled for discussion at the next meeting -

Support network for vulnerable elderly people and the elderly suicide problem;
Follow-up on Neighborhood Level Community Development Project services; and
Discussion on the Mental Health (Amendment) Bill 1997

4.The Administration would be requested to provide an information paper to the Panel on the estimated budget for welfare services (including items under the "baseline plus") for 1997/98.	Adm

III.Welfare services for new immigrants from China

(Paper No. CB(2)1485/96-97 (01))

5.The Deputy Director (Social Welfare) ( DD(SW) ) revealed that $3.7 million, representing an increase of about 38% over the previous year, had been allocated for providing post-migration services to new immigrants in 1997/98.

6.In response to a members enquiry, DD(SW) explained how the Social Welfare Department (SWD) coordinated with non-governmental organizations (NGOs) in providing post-migration services for new immigrants. DD(SW) said that dedicated services tailored to the needs of new immigrants were offered by the Hong Kong branch of the International Social Services (ISS - HK) during the first year of arrival of the immigrants. Being the first point of contact with new immigrants, ISS - HK would also identify cases which were in need of more intensive casework service and refer them to either SWD or NGOs. She explained that courses targetted to help new arrivals integrate into the community were organised by SWD and NGOs during their first years residence in Hong Kong, and new immigrants could obtain information on these courses and other post-migration services run by NGOs from SWD and also by taking part in the activities jointly held by NGOs and SWD.

7.A member asked if ISS - HK could ensure that each new immigrant could at least attend one session of the orientation programme organized by ISS - HK to help him get acquainted with the local community. In response, the Assistant Director of Social Welfare (Family and Child Welfare) ( AD(FCW) ) explained that participation in the orientation sessions was on a voluntary basis, and some with family and/or friends living in Hong Kong might not need such service. Nevertheless, ISS -HK would follow up with those new immigrants who had not attended any of the orientation sessions to explain to them the usefulness of these sessions in a bid to encourage them to attend. AD(FCW) said that the majority of new immigrants had attended these orientation sessions.

8.DD(SW) informed members that subvention had been allocated by the Education Department to NGOs to provide services for the new arrival students.

9.At the Chairmans enquiry, DD(SW) pointed out that the Immigration Department (ID) would refer cases involving mothers who were illegal immigrants or on two-way entry permits but needed to stay in Hong Kong to take care of their children to the SWD for assessing the needs of the families concerned and whether the mothers should be allowed to stay. The final decision would rest with ID.

10.A member asked if the Administration could lay down specific guidelines to explain the circumstances in which the mother would be allowed to stay in Hong Kong to take care of her children. AD(FCW) replied that it was not possible to lay down precise criteria for compassionate residency but each case would be assessed on its own merits. She explained that in general families with compelling social or medical grounds (such as serious illness or sudden death of the father) in support of the mothers stay in Hong Kong would be recommended. Members requested the Administration to consider setting out clear guidelines for handling such cases.

Adm

11.At members enquiry, DD(SW) reported that 19 and 55 additional caseworkers had been provided for NGOs and SWD respectively in 1996/97. She would provide information on the manpower, caseload and locations of the NGOs which had been given the additional caseworkers.	Adm

12.A member queried the difference in functions between the standing District Service Coordinating Committees (DSCC) of SWD and the District Steering Committee (DSC) of the Home Affairs Department. In response, AD(FCW) explained that DSCC conducted regular meetings attended by representatives of both SWD and NGOs in a bid to strengthen their coordination in rendering welfare services to new immigrants in the district. She explained that DSC was different in that its meetings were attended not only by representatives of SWD but also by officers of relevant departments at district level to tighten inter-departmental coordination in providing services for the new arrivals.

13.A member asked if it was possible for the Administration to obtain profiles of prospective immigrants before they arrived in Hong Kong so that the Administration could estimate in advance the particular needs for welfare services in respect of these new immigrants. In reply, DD(SW) reported that ISS had already commenced work in this direction as it had recently set up a centre in Guangzhou to start making contacts with the prospective Hong Kong immigrants before they left for Hong Kong, and to make early preparations for the post-migration services which they would need. The centre was currently financed by ISS.

14.AD(FCW) revealed that there was an on-going programme to expand child care centres places to cope with district demand subject to availability of suitable premises. She confirmed that the expansion programme had covered districts like North Point and Kwun Tong.

15.DD(SW) agreed with a member that there was a need for the Administration to strengthen its role in coordinating the services rendered by ISS - HK and the Red Cross, which was recently engaged to assist SWD in implementing the Portable Comprehensive Social Security Assistance scheme in Guangdong. She further cited the visit to Guangzhou to be taken by the Director of Social Welfare ( D(SW) ) as an example of the new initiatives for strengthening cooperation with China in the provision of services for the elderly and the new immigrants.

IV.Rehabilitation and support services for ex-mental patients

(Paper Nos. CB(2)1485/96-97 (02) and CB(2)1515/96-97)

16.Mr Joseph CHAN of the Hong Kong Council of Social Service (HKCSS) presented the paper on the inadequacies of social support for discharged mental patients and their families. In addition, Ms Stella HO and Ms Deborah WAN of HKCSS supplemented the following problems which had also been identified -

Only about 10% of discharged mental patients were allocated half-way house places and the majority were discharged directly to the community; and
allocation of resources to support care services for people suffering from minor psychiatric problems such as depression and tension was severely inadequate.

17.Ms Deborah WAN concluded that the Administrations target of providing seamless care to the discharged mental patients had been seriously hampered by the lack of community support and inadequate resources.

18.A member criticized that the ratio of aftercare workers to clients being 1 to 4,000 was unacceptable. In response, the Commissioner for Rehabilitation (C for R) explained that many of the discharged mental patients were reluctant to receive aftercare services because they did not want others to know that they had suffered from mental illness before. He pointed out that aftercare service was also rendered by the community psychiatric teams and community psychiatric nurses of the Hospital Authority (HA) and social workers under the supported employment service subvented by the Government. The Assistant Director of Social Welfare (Rehabilitation) ( AD(R) ) reported that at the end of February 1997, there were 573 waitlistees for half-way houses, 29 waitlistees for supported hostels and 984 waitlistees for long stay care homes (LSCH).

19.The Senior Manager (Professional Services) (SM) of the Hospital Authority (HA) briefed members that medical rehabilitation services had been provided by the 13 Community Psychiatric Nursing Service centres of HA, and the eight community psychogeriatric teams. In addition to the existing four community psychiatric teams to provide support for ex-mental patients, HA had decided (subject to finanlisation of its 1997/98 annual plan) that one more team would be added and deployed in the Hong Kong island.

20.SM explained that a system had been in place to accord priority treatment to patients in need of more urgent psychiatric care. He denied that the consultation time for each follow-up case in the psychiatric out-patient clinic was normally less than five minutes. He believed that it varied depending on patients needs and conditions, and that all patients had been accorded appropriate consultation time.

21.Some members revealed that they had come across many cases complaining that too little time and attention were given by doctors during consultation with mental patients. The Chairman requested these members to provide specific details to SM to follow-up.	Mr TSE Wing-ling & Miss CHAN Yuen-han

22.When asked about the possibility of extending the service hours of psychiatric clinics to the evening, SM replied stating that due to resource constraints, priority had been given to shorten the waiting time for first consultation in specialized psychiatric out-patient clinics. HA would review the need for extension of service hours at a later stage.

23.In response to a members enquiry, AD(R) pointed out that for emergency cases, the hot-line services and round-the-clock psychiatric out-reaching service of SWD were in place to provide assistance. In response to criticisms on the lack of resources support for the self-help groups of relatives of ex-mental patients, AD(R) explained that depending on merits of the individual cases, the Administration would consider giving support to self-help organisations in their applications for welfare premises and charitable funds.

24.As regards the lack of resources to purchase new and more effective drugs for the psychiatric patients, the Hospital Chief Executive of Kwai Chung Hospital (HCE) explained that actually there were also many side-effects with the new drugs. Since there were many underlying reasons for patients reluctance to take drugs, he did not consider that the use of new drugs would really change the attitude of these patients. Moreover, he was of the view that medication only constituted 30% of the factors leading to successful rehabilitation of the mental patients. In response, a member was dissatisfied with the answer and criticized that since the Government had rendered inadequate support in the remaining 70% of the service areas, medication was very important to the rehabilitation of the patients.

25.Members were concerned that 25% of schizophrenic patients required re-hospitalization within 18 months after discharged and doubted the effectiveness of the rehabilitation services provided for ex-mental patients. A member also queried the criteria adopted by the Administration in deciding which ex-mental patient could be directly discharged to the community. He asked whether the Administration had any target of successful rate of rehabilitation to achieve, as he noted that HKCSS had developed such target for their rehabilitation work.

26. In reply, HCE said that the quoted re-admission rate was not relatively higher nor lower compared with overseas countries which were well developed in psychiatric services. He reported that about 85% of the ex-mental patients were discharged directly to the community. He also informed members that HA had been compiling a data base on the patients for analysis of the effectiveness of treatments.

27. After discussion, HA was requested to provide information on -	HA

the re-admission rate of discharged mental patients; and
the average waiting time for first consultation of each psychiatric out-patient clinic;

It was also decided that the LegCo Panel on Health Services should be requested -	Health Services Panel

to discuss whether HA should be required to develop targets of successful rate of rehabilitation; and
to monitor how far HA had fulfilled its service commitment on the targetted waiting time for first consultation of its psychiatric out-patient clinics.

SWD was also requested to provide information on the estimated waiting time on average for the 984 and 573 waitlistees to be admitted to LSCH and half-way houses respectively.	Adm

28.The Chairman concluded that the medical rehabilitation services rendered by HA should be discussed by the LegCo Panel on Health Services, whereas aftercare services provided by SWD should be followed up by this Panel. He agreed that a joint-panel meeting could be arranged with the consent of the Chairman of the LegCo Panel on Health Services.

V.A survey on the needs of single parent families

(LegCo Paper Nos. CB(2)1268/96-97 and CB(2)1395/96-97)

29. At the invitation of the Chairman, Mr Robert NIELD of the Isolin Clague Trust Allocation Committee (the Committee) briefed members on the background of Isolin Clague Trust which was formed in 1989 and dedicated to satisfying the needs which were not met elsewhere of single parents with young children. In the past seven years, the Trust had been used to help 393 families and a total of 831 children. He disclosed that the Trust had sufficient funding to continue providing services until June 1997. He therefore took this opportunity to draw the Administrations attention to the unmet needs of the single parents families and urged the Administration to continue with the work that the Committee had started.

30. Supplementing the submission paper of the Committee outlining six recommendations for the Administration, Ms Cecilia KWAN pointed out that there were no provisions from the public assistance to support the needs of young children of single parent families for private tuition, interest training, child care and recreational expenses. The annual Long Term Supplement (LTS) and the discretionary grant under the Comprehensive Social Security Assistance (CSSA) Scheme had failed to meet the needs of those single parent families on CSSA. The lack of clear and transparent guidelines on the use of these grants had made applications for them very difficult. She further criticized the current monthly standard rate of $230 as single parent supplement was too little and should be adjusted based on the number of children in a family.

31. Ms Cecilia KWAN also pointed out that the Government should provide special assistance to help single parents who were engaged in full-time work. For example, the existing one-month disregarded earnings for CSSA when a single parent started taking up employment should be extended to three months to provide adequate financial support for the parent to make child care arrangement and other necessary adjustments. In addition, the Administration should provide assistance to equip some single parents with the knowledge and skill required in order to take up employment.

32. A member made the following suggestions in relation to the needs of single parent families -	Adm

to provide private tuition allowances for children of these single parent families who had apparent difficulties in their academic studies;
to give advanced payment of the annual LTS to families to cater for their urgent needs for replacements of durable electric appliances;
to pay for the after-school care fee for the children of a single parent who had newly picked up a job; and
to set up a trust similar to the Isolin Clague Trust to continue with the work that it had started or to allocate funds to the Trust when it used up its funding by June 1997.

33. DS(W) had reservation to accede to the requests such as providing assistance to meet the childrens needs for interest training, recreational and private tuition expenses under the existing CSSA system. He suggested that funding of such needs might be obtained from certain charitable trust such as the Sir Robert HO Tung Charitable Funds.

34. The Principal Assistant Secretary for Health and Welfare (Welfare) ( PAS(W) ) supplemented that D(SW) could exercise discretion to issue the discretionary grant to CSSA recipients for the urgent replacement of durable household items. However, members criticized that since such purchases only involved small amounts of money, they should not have to be approved by D(SW). They demanded that D(SW) should delegate the approving authority to other designated officers to expedite payment to the needy.

Adm

35. Members reiterated the need for greater flexibility in granting LTS and discretionary grants to single parent families in view of their unique problems and special needs. In particular, they requested the Administration to give further thought to the suggestions made in para. 32.

VI. Social Security Allowances : Revision of rates under CSSA and the Social Security Allowance (SSA) Schemes

(LegCo Paper No. CB(2)1531/96-97)

36. The Administration had proposed to increase, with effect from 1 April 1997, by 6.5% the standard payments under the CSSA and SSA Schemes, and by 8% the maximum rent allowance under CSSA Scheme. Upon a members request, DS(W) agreed to provide additional information which indicated that the proposed increase for the maximum rent allowance had taken into account the actual rent paid by 90% of the CSSA households living in private housing.

Adm

37. Members queried the basis for not increasing LTS for families with five or more members. In reply, D(SW) explained that the proposal was based on the findings during the CSSA major review which indicated that households with more members did not spend more on durable goods than families of smaller size. However, members considered the Administrations argument tenuous given the varied circumstances of different families and reiterated their suggestion at para. 32 (b) regarding advanced payment of the annual LTS to families to cater for urgent needs for replacements of durable goods.

38.Members enquired about the reasons for the over-projection of the inflation rate in calculating the standard rates under the Comprehensive Social Security Scheme (CSSA) and Social Security Assistance Scheme (SSA) in early 1996. In response, the Government Economist (GE) explained the statistical forecasting methodology employed, which was widely adopted by the advanced countries. He said that adjustments to the standard rates under CSSA and SSA schemes were based on the forecast increase in the Social Security Assistance Index of Prices (SSAIP). The increase for 1996/97 in the SSAIP was forecast at 7% in early 1996, but the actual increase turned out to be much lower than the forecast. The discrepancy was largely attributable to the unexpectedly moderate increase in food prices in 1996 despite floodings in China. Since a high proportion of the CSSA standard payments (43%) was for food expenses, any variation in food prices would have a substantial impact on the SSAIP. Furthermore, the US dollar had remained strong in 1996, and this had a positive impact on the overall inflation rate last year.

39. A member recalled that the "Basic Needs" (BN) approach used by the Government in reviewing the CSSA standard rates did not include any provision for eating out. He enquired about the difference in approach in drawing up the Social Security Assistance Index of Prices (SSAIP). DS(W) explained that the CSSA Scheme did not dictate the spending pattern of its recipients who were free to choose between eating at home or eating out. The Chairman decided that due to time constraint the matter would be further pursued at the next FC meeting when members could request for greater increase in the standard payments especially for the CSSA elderly singletons.

40.The meeting ended at 5: 10 pm.

Legislative Council Secretariat

10 June 1997

Last Updated on 22 August 1998