EC(97-98)43
For discussion
on on 14 January 1998


ITEM FOR ESTABLISHMENT SUBCOMMITTEE OF
FINANCE COMMITTEE

HEAD 149 - GOVERNMENT SECRETARIAT :
HEALTH AND WELFARE BUREAU
Subhead 001 Salaries

Members are invited to recommend to Finance Committee the creation of the following permanent posts in the Health and Welfare Bureau of the Government Secretariat with effect from 14 January 1998 -

1 Administrative Officer Staff Grade B

(D3) ($127,900 - $135,550)

1 Senior Principal Executive Officer

(D2) ($110,000 - $116,800)

PROBLEM

The existing staff establishment in the Health and Welfare Bureau (HWB) is inadequate to handle and oversee policy formulation and implementation of services for the elderly.

PROPOSAL

2. We propose to create permanent posts of one Administrative Officer Staff Grade B (AOSGB) and one Senior Principal Executive Officer (SPEO) to enhance the capacity of the HWB in providing support to the newly established Elderly Commission (EC), and to co-ordinate and oversee policy formulation and implementation of services for the elderly.

JUSTIFICATION

Existing Elderly Services Division

3. An Elderly Services Division (ESD) headed by an Administrative Officer Staff Grade C (AOSGC), designated as Principal Assistant Secretary (Health and Welfare) Elderly Services (PES), was created in the then Health and Welfare Branch in November 1994 to co-ordinate and oversee policy matters relating to welfare, health and medical services for elderly people. Her duty list is at Enclosure 1.

4. Despite the setting up of the ESD in 1994, there is considerable concern in the community that a stronger co-ordination mechanism is required to cover all the needs of the elderly including: health and medical; psychological; care; financial; housing; social and recreational needs. Individually or together, they impact on the overall well-being of the elderly. Care for the elderly should be seen as a continuum and should transcend departmental boundaries.

New initiatives in Care for the Elderly

5. "Care for the Elderly" is one of Hong Kong Special Administrative Region (SAR) Government's Strategic Policy Objectives. In July 1997, the Chief Executive appointed the EC to advise on policy formulation, co-ordination and implementation of services and programmes for the elderly, covering the entire spectrum of their needs. Its remit cuts across policy areas involving a number of policy bureaux, executive organisations and non-governmental bodies (NGOs). To give it the necessary support, a strong team within the HWB is necessary to bring the various service units to work together to provide a full range of services for the elderly.

6. We have drawn up a set of policy commitments and initiatives which aim at providing a sense of security, belonging, health and worthiness to our senior citizens. A major area of improvement and review will be the delivery of housing and residential care service for the elderly. HWB has already embarked on a demand assessment exercise and will recommend to the EC, by summer 1998, a comprehensive strategy to meet long term needs.

7. At present, over half of the residential care places are provided in private homes, but their standard of services varies. As an encouragement to private home operators to raise their standard of service and to complement the number of residential care places provided by subvented homes, the Government will introduce an enhanced Bought Place Scheme (BPS) to purchase 2 400 additional places in the next three years, bringing the total BPS places to 3 600. The HWB will initiate a comprehensive review covering: (a) supply of suitable premises; (b) supply of qualified personnel; (c) terms and conditions of the BPS; and (d) administration of the BPS. These issues require co-ordination amongst many parties, including the Finance Bureau, Planning, Environment and Lands Bureau, Housing Bureau, Education and Manpower Bureau, various Government departments, public agencies and the private sector. HWB has a significant role to play in policy formulation and co-ordinating efforts of all these organisations.

8. For the majority of the elderly who do not reside in residential care institutions, the provision of domiciliary and community support services to facilitate them to age at home is of significant importance. A number of existing services require evaluation and review. In the 1997 Policy Programmes, the Administration has undertaken to conduct a review of the home-help service with a view to improving the quality of service. Carers' support services will be provided through newly established carers' support and resource centres. For the vulnerable elderly, networking and outreaching service will be provided through the establishment of 36 integrated teams. The implementation of these new initiatives require careful co-ordination and close monitoring by HWB.

9. The provision of primary health care to the elderly is another area of major concern. The Department of Health will run 18 elderly health centres in the next two years to provide an integrated preventive and curative primary health care service to elderly living in the community. There will also be 18 visiting health teams to provide preventive primary health care service. These new services will require careful co-ordination to ensure a smooth interface with welfare organisations as well as the Hospital Authority so that the various services are provided in the most cost-effective manner. The EC will exercise a close monitor over the development of these new services and it is the responsibility of HWB to assume a leading co-ordinating role.

Deputy Secretary for a restructured Elderly Services Division

(new post of Administrative Officer Staff Grade B)

10. At present, the Secretary for Health and Welfare (SHW) is supported by two deputy secretaries. DS(HW)1, an AOSGB1, looks after the health and medical aspects, while DS(HW)2, an AOSGB, is responsible for the welfare portfolio. In the light of the enhanced focus given to the growing elderly population and the establishment of the EC, the SHW proposes to create one AOSGB post (to be designated DS(HW)2, with the existing DS(HW)2 to be re-designated as DS(HW)3) in the HWB to co-ordinate policy formulation on all programmes affecting the elderly, covering policy areas both within and outside the HWB. DS(HW)2 will provide the necessary support to the EC, and be responsible for the policy on the comprehensive social security assistance schemes, the majority of which clients are elderly. His proposed duty list is at Enclosure 2.

Deputy Secretary for a restructured Welfare Division

(existing post of Administrative Officer Staff Grade B)

11. DS(HW)3 will exercise policy responsibility for welfare services covering family, children and youth, and oversee the subvention policy and the administration of a number of charitable funds. He will also be responsible for all policy work on rehabilitation. The proposed duty list of DS(HW)3 is at Enclosure 3.

12. A number of family and child welfare issues and the major Review of the Rehabilitation Programme Plan will warrant the full and immediate attention of DS(HW)3 in the coming year. In addition, the need to complete reviews on the provision of school social work services, the Adoption Ordinance, manpower requirements in the social work discipline and the social welfare subvention system will ensure a full workload for DS(HW)3 and his staff.

13. To cope with developments in the adoption service in recent years, we consider it necessary to review the operation of the Adoption Ordinance. The review is expected to cover important issues such as the removal of discriminatory provisions, the introduction of legal control on private adoption, authorisation of NGOs to provide adoption service (local and overseas) and the associated legislative amendments. There will be consultations with the welfare sector, the legal profession and the general public. Furthermore, DS(HW)3 is also responsible for conducting a policy review on the provision of legal representation in care and protection proceedings in the juvenile court. This review will need to take account of the provisions in the United Nations Convention on the Rights of the Child, and the possible extension of the Duty Lawyer Service to these proceedings.

14. Amongst those issues relating to family and child welfare, DS(HW)3 will need to ensure that appropriate legislation is introduced to enable the Hong Kong SAR to comply with its international obligations under the Hague Convention on the Civil Aspects of International Child Abduction. This will ensure that the Convention can be applied to the Hong Kong SAR. In addition to the legislative exercise, DS(HW)3 will also be required to oversee the effective implementation of the Convention among departments to ensure the swift return of abducted children, as and when such cases arise.

15. Furthermore, the Government is developing a new subvention system for the welfare sector. This warrants the full attention of DS(HW)3 to ensure acceptability of the proposals to the sector and their smooth implementation. In the light of public concerns on certain features in the current proposed funding formula, the HWB and the Social Welfare Department will once again consult the welfare sector before finalising the package. The consultation exercise requires close liaison with NGOs and is expected to form a major part of the workload for DS(HW)3 in the coming year. A similar exercise is also required in respect of the control of charitable fund-raising activities.

16. As regards the provision of youth services, DS(HW)3 is actively involved in the review of the school social work service which entails a detailed analysis of the service delivery mode and examination as to how the service can be enhanced in the light of feedback from service providers and clients.

One Senior Principal Executive Officer

17. For the new activities arising from the establishment of the EC, the SHW proposes to create one SPEO (D2), designated as PES2, to head the secretariat of the EC and its committees. As mentioned earlier, the EC's remit covers matters outside the purview of the HWB, and the EC has identified housing for the elderly as a priority item for examination. PES2 will have to liaise closely with the Housing Bureau and other organisations concerned on provision of housing for the elderly. He has also to liaise with Government bureaux/departments in relation to services for the elderly other than health and welfare issues, e.g. employment opportunities for the elderly in order to promote among them a sense of worthiness.

18. Another major responsibility for PES2 is the development and implementation of a strategy to encourage the private sector to provide quality elderly services to complement the existing services operated by the subvented sector in the provision of residential care service for the elderly. This involves a comprehensive review of the BPS, overseeing the implementation of the Residential Care Homes (Elderly Persons) Ordinance and collaborating with various policy bureaux, departments, voluntary organisations and the private sector on the provision of suitable premises and sufficient manpower for operating private elderly homes. The proposed duty list for PES2 is at Enclosure 4. As the main focus of the job is on secretariat and co-ordination duties, an Executive Grade post is considered appropriate.

19. We have reviewed the job duties of the present four Principal Assistant Secretaries (PAS) responsible for welfare and rehabilitation portfolio, and consider that they do not have spare capacity to undertake the new activities set out in paragraphs 17 to 18 above. The two PASs responsible for elderly and social security matters are already fully engaged in taking forward the new initiatives in the 1997 Policy Address. The third PAS looks after all welfare matters other than elderly and social security issues, while the fourth officer, designated as Commissioner for Rehabilitation, covers rehabilitation issues. They are also fully engaged in their own schedules of duties.

20. The revised schedules of duties of PASs in the elderly and welfare divisions in the HWB are at Enclosure 5. The existing organisation chart is at Enclosure 6.

21. A supernumerary SPEO post created in HWB under delegated authority will lapse on 14 January 1998. We propose to create the SPEO post in HWB with effect from the same date to provide continual support to the EC.

FINANCIAL IMPLICATIONS

22. The additional notional annual salary cost of this proposal at mid-point is -



$

No. of Post





New permanent posts

2,941,200

2

The full annual average staff cost of the proposal, including salaries and staff on-costs, is $5,091,048.

23. In addition, this proposal will necessitate the creation of two additional Personal Secretary I posts at a notional annual mid-point salary cost of $551,760 and a full annual average staff cost of $858,792.

24. Funds are available in the 1997-98 Estimates to meet the cost of this proposal.

CIVIL SERVICE BUREAU COMMENTS

25. The grading and ranking of the two proposed posts are considered appropriate having regard to their duties and level of responsibilities.

ADVICE OF THE STANDING COMMITTEE ON DIRECTORATE SALARIES AND CONDITIONS OF SERVICE

26. The Standing Committee on Directorate Salaries and Conditions of Service has advised that the grading proposed for the posts would be appropriate if the posts were to be created.

Health and Welfare Bureau

December 1997

Enclosure 1 to EC(97-98)43

Duty List of
Principal Assistant Secretary (Health and Welfare) Elderly Services
(before re-scheduling of duties)

  1. Policy matters relating to welfare, medical and health services for elderly people.

  2. Setting up and overseeing a consultancy study on the needs of the elderly.

  3. Monitoring the implementation of the recommendations of the Working Group on Care for the Elderly.

  4. Liaison, co-ordination and consultation with government departments and policy bureaux to co-ordinate and promote programmes and policies for elderly people.

  5. Liaison, co-ordination and consultation with non-government organisations, professional groups and other relevant organisations on the needs of elderly people.

Enclosure 2 to EC(97-98)43

Proposed Duties of Deputy Secretary (Health and Welfare) 2

Overall responsibilities

Responsible to the Secretary for Health and Welfare for the formulation, development and implementation of Government policies on care for the elderly and the Social Security Schemes, and co-ordination of various Government programmes provided for the benefit of the elderly.

Specific duties

  1. Providing support to the Elderly Commission in formulating policies and strategies for care for the elderly.

  2. Managing relations with and taking appropriate matters through the Welfare Panel of Provisional Legislative Council.

  3. Devising a strategy to facilitate provision of residential care services for the elderly, working with the Social Welfare Department to monitor the supply and demand for residential care and overseeing the administration of the Residential Care Homes (Elderly Persons) Ordinance.

  4. Providing policy guidance to the Social Welfare Department, Department of Health, and Hospital Authority on community support, health and medical services for the elderly, and monitoring progress and development.

  5. Keeping under review financial assistance for the elderly, including the Comprehensive Social Security Assistance Scheme and Social Security Allowance Scheme.

  6. Liaising with Government Bureaux, Departments, and public agencies in relation to provision of housing, educational and other services for the benefit of the elderly.

  7. Overseeing preparation of input into the Policy Address, the Budget and Resource Allocation Exercise in respect of elderly and social security issues.

Enclosure 3 to EC(97-98)43

Proposed Duties of Deputy Secretary (Health and Welfare)3

Overall responsibilities

Responsible to the Secretary for Health and Welfare for the formulation, development, and implementation of Government policies and programmes on all welfare issues apart from those relating to Elderly and Social Security issues.

Specific duties

  1. Formulating, reviewing and implementing policy proposals on all welfare matters other than elderly and social security issues, and in particular focusing on matters relating to children, youth (at risk), the family, the disabled and subvention to non-governmental organisations.

  2. Managing relations with and taking appropriate matters through the Welfare Panel of Provisional Legislative Council, Social Welfare Advisory Committee, Rehabilitation Advisory Committee and other committees.

  3. Leading and managing the Welfare Division, setting work priorities and output targets.

  4. Overseeing relevant primary and subsidiary legislative amendment exercises.

  5. Manpower planning for social workers and certain allied health personnel providing welfare services.

  6. Administration of various charitable funds and relevant advisory/appeal committees (Lotteries Fund, Jockey Club Shopping List, Hong Kong War Memorial Pensions Fund, Sir Robert Ho Tung Charitable Fund etc).

  7. Overseeing preparation of the welfare input into the Policy Address, the Budget and Resource Allocation Exercise excluding elderly and social security issues.

  8. Overseeing, through the Quarterly Progress Review Mechanism and other means, the financial performance of Social Welfare Department, Skills Centres, Transport Department's Rehabus Service and the Environmental Advisory Service.

Enclosure 4 to EC(97-98)43

Proposed Duties of
Principal Assistant Secretary (Health and Welfare) Elderly Services 2

Overall responsibilities

Responsible to Deputy Secretary (Health and Welfare)2 for secretariat support services to the Elderly Commission, the formulation and implementation of a strategy to develop a quality private sector on the provision of residential care services, and liaising with Bureaux, Departments and other organisations on the provision of adequate housing for the elderly.

Specific duties

  1. Heading the secretariat of the Elderly Commission and its committees, including servicing the central co-ordinating committee on the International Year of Older Persons 1999.

  2. Exercising policy responsibility over the Residential Care Homes (Elderly Persons) Ordinance.

  3. Devising and implementing a strategy to facilitate the development of a quality private sector on residential care for the elderly.

  4. Reviewing the Bought Place Scheme with a view to increasing the number of bought places by twofold in three years, as a means to upgrading quality of private elderly homes.

  5. Liaising with Bureaux, departments and other organisations on the provision of suitable premises and manpower for operating private elderly homes.

  6. Liaising with the Housing Bureau, Housing Department, Hong Kong Housing Society and the Lands Development Corporation on the provision of housing for the elderly, and monitoring progress and development.