Legislative Council
LC Paper No. CB(2) 714/98-99
(These minutes have been seen
by the Administration)
Ref : CB2/PL/WS
LegCo Panel on Welfare Services
Minutes of meeting
held on Monday, 12 October 1998 at 10:45 am
in the Chamber of the Legislative Council Building
Members Present:
Hon CHAN Yuen-han (Chairman)
Hon HO Sai-chu, JP (Deputy Chairman)
Hon Cyd HO Sau-lan
Hon LEE Cheuk-yan
Hon Eric LI Ka-cheung, JP
Hon LEE Kai-ming, JP
Hon Fred LI Wah-ming
Hon Ronald ARCULLI, JP
Dr Hon YEUNG Sum
Hon YEUNG Yiu-chung
Hon CHOY So-yuk
Hon LAW Chi-kwong, JP
Member Absent:
Hon David CHU Yu-lin
Member Attending:
Hon TAM Yiu-chung, JP
Public Officers Attending :
- Mrs Katherine FOK, JP
- Secretary for Health and Welfare
- Mr Andrew LEUNG, JP
- Director of Social Welfare
- Mrs Louise WONG, JP
- Deputy Director of Social Welfare (Administration)
- Mrs Patricia CHU
- Deputy Director of Social Welfare (Services)
- Mr HO Wing-him
- Deputy Secretary for Health and Welfare (2)
- Mr Robin GILL
- Deputy Secretary for Health and Welfare (3)
- Mr LO Chi-hong
- Principal Assistant Secretary for Health and Welfare (Welfare 1)
- Miss Victoria TANG
- Principal Assistant Secretary for Health and Welfare (Welfare 2)
- Miss Monica CHEN
- Principal Assistant Secretary for Health and Welfare
(Elderly Services 1)
- Mr Laurence LIU
- Principal Assistant Secretary for Health and Welfare
(Elderly Services 2)
- Mr Augustine CHOI
- Commissioner for Rehabilitation
- Mr Y K CHENG
- Assistant Director (Applications and Home Ownership)
Clerk in Attendance:
- Ms Doris CHAN
- Chief Assistant Secretary (2) 4
Staff in Attendance:
- Mrs Justina LAM
- Assistant Secretary General 2
- Mrs Eleanor CHOW
- Senior Assistant Secretary (2) 4
I. Briefing by the Secretary for Health and Welfare on the Chief Executive's Policy Address 1998
The Secretary for Health and Welfare (SHW) assured members that despite the recent changes in the economic environment, the programmes set out in the Policy Address 1997 would be undertaken and funds would be allocated as scheduled. She then highlighted the welfare programmes for the coming year.
Family and child welfare
2. SHW said that in response to the economic downturn and the rise in unemployment in Hong Kong, the Administration planned to strengthen the family casework service by providing 29 additional family caseworkers in the coming year, so as to render assistance and counselling service to those in need. The number of family caseworkers would increase to 760 in 1999-2000.
3. On child welfare, SHW said that 23 additional child protection workers would be provided by 2000-2001. Efforts would be strengthened to improve treatment and other supporting services for victims of child abuse and their families. Publicity and public education programmes would continue to be launched to promote public awareness of the impact of child abuse on affected children and their families.
Care for disabled persons
4. SHW said that the Government was committed to providing quality rehabilitation services to facilitate people with disabilities to integrate into the community and to enable them to realize their full potential. There were at present 23 000 day care and residential places and over 1 000 places in technical training centres for persons with disabilities. The improvements in 1999-2000 included 480 additional day and residential places for people with disabilities and the provision of an Infirmary Care Supplement to an additional 28 frail elderly living in homes for the aged blind.
5. SHW further said that to better assess the demand for rehabilitative services and support, a comprehensive review would be completed in 1999 which would help to plan the rehabilitative programme for the next five years. In order to meet growing demand, over 3 000 additional day and residential places would be provided in the next few years.
Review of Comprehensive Social Security Assistance (CSSA) Scheme
6. SHW said that spending under CSSA rose rapidly from $2.4 billion in 1993-94 to $9.4 billion in 1997-98 and was expected to reach $13 billion this financial year. This represented five-fold increase in five years. It was necessary to slow down the growth in CSSA expenditure as it was difficult for a non-contributory social security system to support such a rise.
7. SHW said that in accordance with a study conducted earlier by the Social Welfare Department (SWD), many unemployed CSSA recipients would like to rejoin the workforce if provided with necessary assistance. The SWD planned to introduce a series of measures to help and encourage those unemployed CSSA recipients to find jobs.
8. In order to ensure that public resources were used to help those most in need, SHW said that the SWD would strengthen its establishment to provide intensive assistance to the unemployed recipients, to cope with increase in caseload and to detect fraud.
9. SHW said that she had noticed that the public was concerned about the level of assistance provided to larger households, for example a family of four was receiving on average $11,000 a month which would in some case be higher than the income of a four-member family. She said that the CSSA payment for large families was being reviewed. The review would take into consideration day to day essential expenditure of a family on one hand and would ensure on the other hand that the level of assistance was not out of line with reality. SHW said that the Bureau was currently finalizing the review and would put forward recommendations by the end of this year.
Services for the elderly
Increase the supply of residential care services
10. SHW said that the Elderly Commission had submitted a report to the Chief Executive (CE) on assessment of the demand for residential care services and had drawn up a long-term strategy to address the problem. To meet the genuine demand, with the aim to gradually reduce the waiting time, the Administration planned to provide 8 000 new subsidized places in the next three years, including an addition of 880 bought places. It was projected that the number of elderly with genuine demand would then be further reduced to about 7 000. With the completion of various programmes, the expenditure on residential care services was estimated to increase from the present $1.3 billion to $1.8 billion by 2002, with a total supply of 24 000 subvented residential places.
Assistance to demented elderly
11. SHW said that starting from November 1998, a Dementia Supplement would be made available to 200 demented elderly persons in residential care homes. Having regard to the increasing number of demented elderly in the institutions, additional funding of $6 million would be allocated to the home care for a further 160 demented elderly in 1999-2000. In addition, pilot schemes would be conducted in day care centres and residential care homes to provide dedicated service for the demented elderly. The Administration would in the next few months work out specific details for the pilot schemes.
Home help services
12. SHW said that majority of elderly people wished to continue to live at home and be cared for by their families. Many families also preferred to take care of their elderly at home provided that the assistance needed was available. It had been the policy of the Government to encourage families to assume such role and to provide the necessary support services to families. In the coming year, 15 additional Home Help Teams would be established. Together with the 15 Teams which would be set up in the current financial year, the capacity of home help services would be expanded by over 20% to 156 teams within two years.
13. SHW further said that in order to enhance the quality of the current home help service and secure good value for money, the current service would be reviewed to identify ways to upgrade it through re-engineering.
Respite service
14. SHW said that as taking care of elderly persons at home could be strenuous task, the Administration planned to launch pilot projects to introduce a new respite service in day care centres for the elderly. The new service aimed to provide short term relief to informal carers who were caring for their elderly family members at home.
15. SHW concluded that the Government had injected substantial resources to improve various welfare services in the past years. It remained the Government's objective to improve service quality and work closely with non-governmental organizations with a view to enhancing productivity and exploring new avenues in the provision of various welfare services.
Questions by members
CSSA Scheme
16. Dr YEUNG Sum cautioned that when making remarks about the increase in CSSA expenditure, the Administration had to make clear it was not attributed to unemployed persons only, given that there was an increasing number of applications from the elderly as a result of the ageing population. He said that the public's misconception that the unemployed were taking advantages of the CSSA would put undue pressure on the unemployed. Some of them might resort to tragic means instead of seeking welfare assistance.
17. Mr Fred LI said that the remarks about a four-member family getting a monthly payment of $11,000 from CSSA had misled the public that unemployed people chose to live idly. He asked the Administration to provide information on the average income of a four-member household.
18. Director of Social Welfare (DSW) clarified that information about CSSA expenditures was recently presented to the media. Different reporters might have different focuses and some obviously were more interested in figures for extended family and hence gave it more news coverage. He said that the Administration had no intention to mislead the public. He confirmed that the majority of CSSA recipients were the elderly, persons with disabilities or chronic diseases, while the unemployed accounted for about 12% of the total caseload. He however noted that applications for CSSA from the unemployed had increased substantially recently. He informed members that a recent survey conducted by the SWD revealed that unemployed CSSA recipients had difficulty in finding jobs because they generally lacked special skill, were not well-educated and middle-aged or above. He said that the Government would continue to provide various assistance to help the unemployed CSSA recipients to rejoin the workforce. He reassured members that it remained the Government's policy to provide a safety net for those who were unable to meet the basic needs.
19. SHW said that she had quoted the average CSSA payment for a family of four as an example to show public concern over the increase of CSSA expenditures. She did not intend to create disharmony in the community. She said that the survey conducted by SWD revealed that the unemployed wished to have jobs and definitely did not wish to rely on CSSA. The Administration would devise a multi-pronged approach to help them to overcome psychological and technical obstacles. For instance, to provide retraining programmes and to encourage them to participate in community service to regain their self-esteem.
20. Referring to Mr Fred LI's earlier question which the Administration had not answered, Mr LAW Chi-kwong said that the average income of a four-member household was $18,000.
21. Mr LEE Kai-ming said that some unemployed persons might refrain from applying for CSSA due to public pressure. He asked what kind of assistance would be provided to this group of people. He also asked the Administration to explain how the growth rate of CSSA expenditure could be slowed down in the face of the present economic situation and a growing ageing population. The Chairman shared the same concern and commented that slowing down CSSA expenditure might not be the right solution to the problem at the present time.
22. DSW admitted that ageing population was a serious problem because it was estimated that elderly people would constitute 20% of the population by 2016. In view of the problem and the change in economic situation, the Government would endeavour to slow down growth of CSSA expenditure by the following means-
- to encourage families to live with and give support to their elderly members, given that families had always been the main source of financial support for the elderly. People taking care of their aged relatives would be given tax incentives, public housing privileges and various assistance;
- to review the CSSA Scheme with a view to ensuring that CSSA payments would only be paid to those with genuine need; and
- to encourage the unemployed to find jobs. The amount of CSSA payments to the able-bodied recipients might be reduced, because high CSSA payments would create a disincentive to work and might encourage more people to apply for CSSA. The SWD would work closely with the Labour Department to enhance re-training programmes, provide psychological counselling and employment services to the unemployed CSSA recipients.
23. SHW said the CSSA expenditure accounted for a significant portion of welfare spending in Hong Kong. She reiterated that Hong Kong would not be able to meet the rising demand for welfare services and social security payment which relied solely on tax income. It was important that public money be prudently spent and that scarce resources be used effectively and in a targetted manner. The social security schemes aimed to meet the basic needs of the disadvantaged including the financially vulnerable, the elderly and people with disabilities. The objective in operating the CSSA scheme was to provide a safety net to people in real need. The CSSA review aimed to ensure that the Scheme would continue to help those who could not fend for themselves. At the same time, the Scheme had to encourage and help "employable" recipients to become self-reliant and re-join the workforce.
24. In response to Mr Fred LI, SHW said that the Bureau was finalizing the CSSA review and would put forward recommendations by the end of the year. The Chairman pointed out that the subject was last discussed by the Panel in July 1998 while discussion of the final report on the CSSA review had been deferred from September to December 1998.
25. On the Special Investigation Team, Mr YEUNG Yiu-chung asked whether it was cost effective to create 200 additional posts to detect fraud. Mr Eric LI asked about the function and operation of the Special Investigation Team, how the manpower resources would be deployed and whether employment would be offered on contract or permanent terms. He opined that the procedure for CSSA applications should be simplified as far as practicable.
26. DSW explained that the new posts were created not only to handle fraud cases but also to process applications and provide intensive assistance to the unemployed applicants. He explained that every step of the vetting procedure for CSSA application would help prevent fraud. It was necessary to ascertain in each and every application that the need was genuine, given the limited resources available.
| 27. SHW said that there were at present over 200 000 CSSA cases and the number was growing. It was therefore necessary to strengthen the social security field units to cope with increase in caseload and to shorten the waiting time. To address Mr Eric LI's concern in paragraph 25 above, SHW undertook to brief members on deployment of the 200 additional staff at a later Panel meeting.
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Services for the elderly
28. Dr YEUNG Sum said that as there were many elderly persons on the waiting list for residential care service he was concerned that there were insufficient places to meet the demand.
29. SHW replied that the Administration had explored various means to increase the supply of residential care places. Apart from the conventional way of constructing residential care homes to meet long-term needs, the Administration planned to increase the supply through the Bought Place Scheme (BPS) to meet demand in the short-term. Since the initial response on BPS was favourable, the Administration planned to buy an additional 600 places from private care homes which were of good quality. At the same time, new public housing estates and three Government sites would be developed to provide premises for elderly care homes. The waiting time for elderly home places should be substantially reduced within four years.
30. Mr Fred LI commented that the supply of residential places for the elderly was consistently lagging behind schedule. For instance, it was pledged in 1993 that the residential care places in care-and-attention homes and homes for the aged would be increased by 5 888 in 1997 but in the end there was a shortfall of 420 places. He doubted whether the Administration could meet its target set out in the 1998 Policy Address. He further questioned the feasibility of BPS given that 80% of the private care homes were not licensed because of non-compliance with the statutory requirement.
31. SHW assured members that it was the intention of the Administration to increase supply in light of the heavy demand for residential care places. She reiterated that the Administration would not buy sub-standard home places. With rent being greatly reduced as a result of economic downturn, more private care homes had come into operation and the majority of them were licensed. The BPS therefore could be implemented without much difficulty. In addition, the Administration would step up the construction of residential care homes and was currently considering to use some of the vacant premises in public housing estates as residential care homes for the elderly.
| 32. Mr HO Sai-chu said that having regard to the selling price of private properties having been substantially reduced by over 50% in 1998, the Administration should consider buying flats to provide residential care homes for the elderly. SHW undertook to consider the suggestion.
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33. Mr LEE Cheuk-yan considered that the increase of $380 in monthly CSSA payment to the elderly recipients was insufficient to meet their practical needs. He recalled that back in 1995-96 Members of the former Legislative Council demanded that the monthly payment be increased by $800. He was concerned that if there was no further increase in 1999-2000, the elderly recipients would have to live with the meagre increase of $380 for a few more years. He enquired whether the Administration would change its position on the matter.
34. SHW responded that the additional monthly payment of $380 for elderly CSSA recipients was only implemented in April this year in accordance with the pledge made in the 1997 Policy Address. She said that the Administration would review the matter before deciding whether to adjust the allowance in the future.
35. In response to Mr LEE Kai-ming, SHW confirmed that while the normal old age allowance of $650 available to elderly persons aged 65 to 69 was subject to income and asset limits, the higher old age allowance for those aged 70 and above was not subject to means test. There was at present no proposal to change the eligibility criteria of the scheme.
36. SHW further said that elderly persons required more than just financial assistance. The Administration had made a number of pledges to provide a sense of security, a sense of belonging and a feeling of health and worthiness among the elderly. Other than addressing the needs of the current generation of elderly people, the Mandatory Provident Fund would come into operation in 2000 to ensure that future generations would be provided for after retirement.
Family and Child Welfare
37. Miss Cyd HO doubted whether the addition of 29 family caseworkers in the next fiscal year would be enough to meet the demand arising from families of the unemployed and new arrivals from the Mainland. She enquired how many additional caseworkers were needed to meet the growing demand. She also asked how often a family caseworker visited families in need.
38. DSW replied that family cases were ever increasing and SWD would strive to make the best use of resources to meet the demand. He said that in assessing whether family casework services had been strengthened, one should not only look at the number of cases handled, but also consider the way in which the cases were handled and whether they were handled in the most efficient and effective manner.
39. Deputy Director of Social Welfare (Services) (DDSW) said that on average a caseworker would visit a family once a month. However, for families with serious problems, visits would be more frequent. She said that the figure applied to both SWD and the NGO services.
40. In response to a further question from Miss HO, DSW said that it was not unprecedented for voluntary organizations to refuse to take on new cases because of a manpower shortage. He said that the SWD would take up these referral cases when required.
41. Mr LAW Chi-kwong advised that at the present a family caseworker handled about 78 cases a month. In order to meet the target of 60 cases per caseworker per month, an additional 228 caseworkers were required instead of the proposed 29. He further pointed out that the number of family cases had increased by 13% in the past year whereas the proposed addition of 29 caseworkers only represented an increase of 4% in manpower.
42. In response to a question from Mr Fred LI on the same subject, DDSW clarified that the target was 70 cases per worker per month as set out in the White Paper on Social Welfare. She explained that the additional 29 caseworkers would help to meet the increase in service demand and improve service quality by relieving the caseload of family caseworkers. By 1999-2000 there would be 760 caseworkers handling 53 200 family cases.
Mr LAW Chi-kwong informed members that the targetted caseload for each caseworker in 1981-82, 1992-93 and 1998-99 was 50, 65 and 70 per month respectively.
43. Mr LEE Kai-ming asked whether the 29 family caseworkers would provide counselling service to families of the unemployed. DSW replied that the economic downturn had given rise to increased family problems. The problems were complex and often required co-ordinated efforts from various government departments, but the most effective solution was to help the unemployed find jobs. He said that people who were unemployed for a long time often had doubts about their ability to resume work even if there was a job offer. Under such circumstances, the family caseworker would provide psychological counselling and other necessary assistance to the unemployed individual and his family.
44. In response to Mr HO Sai-chu, SHW explained that new arrivals from the Mainland were most concerned about accommodation, employment and education for their children. Most of these families were able to integrate into the society once these concerns were resolved. In the event that these families encountered financial or other family problems, specific services would be rendered on a need basis.
In response to Mr LAW Chi-kwong, SHW confirmed that the additional 23 child protection workers would be spread over a two-year period from 1999-2000 to 2000-2001.
School Social Work Service
45. Mr HO Sai-chu was of the view that one social worker should be provided to each school so that students could receive better support services. He considered that the present manning scale based on the student population was unsatisfactory.
46. DDSW responded that the Review on School Social Work Service was nearing completion and the Working Group had received many submissions expressing different views on the issue. The Working Group would examine the effectiveness and the provision of the existing school social work service taking into account other school-based and non-school-based youth support services. They would also consider how resources should best be deployed before submitting a final report to the Health and Welfare Bureau.
Enhanced Productivity Programme
47. Referring to the Enhanced Productivity Programme proposed by the CE to create an efficient and cost-effective government, Miss Cyd HO asked what measures would be implemented by the Bureau in order to achieve the 5% productivity gain by 2002.
| 48. SHW replied that the Bureau had first to conduct internal discussions before finalizing a detailed implemetation programme. She undertook to brief members on the details in due course. She also assured members that any productivity gain would not be achieved at the expense of service quality.
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II. Date of next meeting
49. The next meeting would be held on 19 October 1998 at 10:45 am.
50. The meeting ended at 11:55 am.
Legislative Council Secretariat
10 November 1998
