EC(1999-2000)14

For discussion
on 9 June 1999

ITEM FOR ESTABLISHMENT SUBCOMMITTEE
OF FINANCE COMMITTEE

HEAD 170 - SOCIAL WELFARE DEPARTMENT
Subhead 001 Salaries

Members are invited to recommend to Finance Committee -

1. the creation of the following new rank in the Directorate -Chief Clinical Psychologist(D1) ($98,250 - $104,250); and

2. the creation of the following permanent post in the Social Welfare Department -1 Chief Clinical Psychologist(D1) ($98,250 - $104,250)

PROBLEM

The current directorate structure in the Social Welfare Department (SWD) is inadequate to respond to changes in responsibility and complexity in the clinical psychology field.

PROPOSAL

2. We propose to create a new permanent post in the new rank of Chief Clinical Psychologist (CCP) pitched at the Directorate level (D1) to strengthen the directorate structure in SWD and to head the Clinical Psychological Service.

JUSTIFICATION

Growth in demand of the clinical psychological service

3. Clinical psychology (CP) specialises in the study, assessment, diagnosis, and treatment of individuals with intellectual, psychological and behavioural problems. The service has grown rapidly in Hong Kong to cope with changing circumstances in the community. Professional CP services are provided in the following areas of work -

1. individuals and families undergoing psychological trauma, crisis such as domestic violence and large scale or traumatic disasters;

2. SWD's Child Protection Service Unit and Child Custody Service Unit in their investigation of suspected child abuse cases especially sexual abuse cases, and child custody cases;

3. day and residential services for young offenders, children and youth with psychological and behavioural problems, mentally handicapped adults and disabled children with special needs;

4. mentally handicapped persons in leading a normal married life;

5. vulnerable witnesses including children and mentally handicapped persons in giving expert evidence in court;

6. mentally ill, sexual offenders, depressed elderly and clients with suicidal tendencies; and

7. promotion of good mental health through preventive efforts including mental health education and stress management.

4. In the past five years, the CP service in the welfare sector has expanded rapidly. The CP establishment in SWD has increased from 22 in 1994-95 to 41 in 1998-99 and in non-governmental organisations (NGO), from ten to 21. An additional four CPs posts will be provided in 1999-2000 bringing the total provision to 67. In terms of performance indicators, in 1998-99, Clinical Psychologists in SWD and NGOs conducted 314 intellectual assessments, 1 734 diagnostic assessments and provided psychological treatment services to 1 956 customers. We expect the need for psychological treatment and CPs' contributions will further increase especially in the light of the current economic difficulties. With the growing diversity and complexity of the service, as set out in paragraph 3 above, and because Senior Clinical Psychologists (SCP) have to be directly involved in service delivery in addition to their supervisory responsibility towards CPs, overall guidance from a senior level within the CP grade is necessary for both CPs as well as SCPs. There is therefore a need to create a CCP as head of the Clinical Psychological Service in SWD to strengthen the service's management with a view to improving the service.

Inadequacies of the existing structure

5. At present, each Clinical Psychology Unit (CPU) is headed by a SCP in SWD's Regional Offices. The SCP, in turn, reports to the Regional Social Welfare Officer, who is a social worker by profession. At the headquarters, Clinical Psychological Service is under the purview of Deputy Director (Services), underpinned by the Assistant Director (Family & Child Welfare) (AD(FCW)). As both the Regional Social Welfare Officers and AD(FCW) are social workers by profession, they do not possess the necessary professional skills/knowledge to assess and monitor the performance of CPs. This is a major hindrance to the further development of the CP service. The proposed CCP, possessing managerial experience, professional connections, as well as expert knowledge in the field, will be able to commit himself/herself fully to the strategic planning and development of clinical psychological services in a changing environment.

6. The AD(FCW), who is currently responsible for the family and child welfare programme, is heavily committed and cannot accord attention to the development and monitoring of the CP service which cuts across a wider spectrum of welfare services as illustrated in paragraph 3. The four SCPs in SWD, are heavily involved in frontline work, clinical consultation and staff management. It is therefore necessary to create a CCP post to be directly responsible to the Deputy Director (Services) to assess the demand for CP service, oversee the future development of the service, formulate strategies for preventive mental health work and improve productivity and efficiency in the service in the welfare sector. He/she will be able to strengthen oversight of this important and growing specialist service so as to improve the productivity and efficiency of the service delivered by the Department and NGOs. The CCP will also need to maintain a close dialogue with tertiary institutions for the supply of CPs and network with international professional organizations in order to maintain and enhance the standard of service.

Review of the existing mode of service delivery

7. CPs provide support to a wide range of welfare services including family and child welfare, elderly, rehabilitation, youth and juvenile offenders. Due to enhanced public awareness and expectations, it is imperative to examine critically the present mode of service delivery and to develop a strategy to ensure that it is able to meet community needs. The current economic situation may also intensify personal and family problems that require the assistance from professional clinical psychological services. The present mode of CP service consists mainly of conducting intellectual assessments for the mentally handicapped, and providing diagnostic assessments and psychological treatment for clients with psychological problems. The CCP will review the present delivery of services and spearhead initiatives to improve service delivery. Such initiatives include preventive action initiatives, use of treatment groups, strengthening consultation with allied health professionals and developing new means of treatment. At the same time, the CCP can research into and monitor quality standards to increase the cost-effectiveness of the CP service. In view of the continuous development in knowledge and skills in clinical psychology and the need to sustain quality and efficient service, we consider that such reviews and service monitoring activities must be an on-going initiative to be led by an officer at the directorate level.

Management and training of CP grade

8. There are no formal guidelines and mechanisms to evaluate CPs' professional work at present. The CCP as manager of the grade in SWD, will set service quality standards, draw up performance indicators, develop core competencies and criteria to assess the performance of CPs working in the department and NGOs.

9. In response to changing needs in the community, new approaches in the delivery of CP services will need to be developed and more effective treatment approaches initiated. The CCP will oversee the development of new treatments, assess the reliability and validity of new treatment tools, and provide professional consultation and advice to SCPs and CPs on case handling. With the creation of a CCP, SCPs will be able to spare more time for direct operational CP service and improve their supervision of staff given that over half of CPs have less than three years of experience.

10. The CCP will identify the training needs for the service and develop suitable training strategies to facilitate CPs' professional development. The CCP will also be responsible for managing manpower resources in the Department, examine and propose ways of enhancing the clinical skills of CP grade staff and co-ordinate among CPs with different specialties to deliver quality service to the public. In addition to overseeing the provision of developmental and remedial services by CPs and SCPs, the CCP will also be responsible for devising forward looking strategies to deal with social problems which arise as a result of societal changes, to advise on adjustments in the mode of service delivery and provision, and to work closely with senior personnel in other disciplines in order to strengthen multi-disciplinary intervention when dealing with complicated problems. Such activities will ultimately have a positive impact on clients. All of these duties require the continuous attention of a designated professional at the directorate level with extensive experience in the field as well as the vision and ability to plan for future service development and to plan and develop training to match service needs.

11. The duties and responsibilities of the proposed CCP post are at Enclosure 1. The current and proposed organizational structure of SWD's Headquarters are at Enclosure 2 and 3 respectively.

Encl. 1 Encls.2&3

FINANCIAL IMPLICATIONS

12. The additional notional annual salary cost of this proposal at MID-POINT is $1,213,200. The full annual average staff cost of the proposal, including salary and staff on-cost, is $2,112,204.

13. In addition, this proposal will necessitate the creation of one additional Personal Secretary II post at a notional annual mid-point salary cost of $181,920 and a full annual average staff cost of $303,720.

14. We have included sufficient provision in the 1999-2000 Estimates to meet the cost of this proposal.

CIVIL SERVICE BUREAU COMMENTS

15. The department has considered carefully alternative means to provide the appropriate level of service bearing in mind the need for efficiency and productivity but considers this proposal the most appropriate way to proceed. Having regard to the reasons put forward, Civil Service Bureau considers the proposal justified and the grading and ranking appropriate.

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

16. The Standing Committee on Directorate Salaries and Conditions of Service has advised that the proposal is appropriate.

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Health and Welfare Bureau
May 1999

Enclosure 1 to EC(1999-2000)14

Duty List of Chief Clinical Psychologist (D1)

Responsible to the Deputy Director of Social Welfare (Services)(D3) for the following -

1. Formulating policies relating to the delivery of clinical psychological services to meet community needs, including preventive and remedial services.

2. Reviewing the existing mode of service delivery and developing strategies for future improvement.

3. Devising service standards for the Clinical Psychologist (CP) grade.

4. Managing service standards and developing special treatment approaches in the delivery of psychological service.

5. Convening, co-ordinating and participating in committees and working groups on policy issues relating to psychological service.

6. Overseeing the operation of the Clinical Psychology Units of the department and ensuring uniformity in the provision of service.

7. Managing the CP grade, and providing expert advice on the development and training of CPs in the department and non-government organisations.

8. Initiating and coordinating research to improve service quality to meet the changing needs of the community.

Enclosure 2 to EC(1999-2000)14

Existing
Organisation Chart in Social Welfare Department's Headquarters

Enclosure 3 to EC(1999-2000)14

Proposed
Organisation Chart in Social Welfare Department's Headquarters