Legislative Council

LC Paper No. CB(2) 439/98-99
(These minutes have been
seen by the Administration)

Ref : CB2/PL/WS

LegCo Panel on Welfare Services

Minutes of Meeting
Held on Monday, 14 September 1998 at 10:45 am
in Conference Room A 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 LEE Kai-ming, JP
Hon Fred LI Wah-ming
Dr Hon YEUNG Sum
Hon YEUNG Yiu-chung
Hon CHOY So-yuk
Hon LAW Chi-kwong, JP

Members Absent :

Hon David CHU Yu-lin
Hon Eric LI Ka-cheung, JP
Hon Ronald ARCULLI, JP

Public Officers Attending :

Item III - Welfare Services for the Elderly

Mr HO Wing-him

Deputy Secretary for Health and Welfare (2)

Mrs Patricia CHU

Deputy Director of Social Welfare (Services)

Miss Monica CHEN

Principal Assistant Secretary for Health andWelfare

(Elderly Services 1)

Mr Lawrence LIU

Principal Assistant Secretary for Health and Welfare

(Elderly Services 2)

Mr LO Chi-hong

Principal Assistant Secretary for Health and Welfare (Welfare 1)

Mrs Eliza LEUNG

Assistant Director of Social Welfare (Elderly and Medical

Social Services)

Mr CHENG Chok-man

Chief Social Security Officer (2)

Item IV - Employment Situation of Social Work Graduates

Mr Robin GILL

Deputy Secretary for Health and Welfare (3)

Mrs Patricia CHU

Deputy Director of Social Welfare (Services)

Miss Victoria TANG

Principal Assistant Secretary for Health and Welfare (Welfare 2)

Mrs Katherine SHIN

Chief Social Work Officer (Training)

Clerk in Attendance :

Ms Doris CHAN

Chief Assistant Secretary (2) 4

Staff in Attendance :

Ms Joanne MAK

Senior Assistant Secretary (2) 4

I.Confirmation of minutes of meeting held on 27 July 1998

(LC Paper No. CB(2) 198/98-99)

The minutes of the last meeting held on 27 July 1998 were confirmed.

II.Date of next meeting and items for discussion

2.In view of the fact that the meeting scheduled for 12 October 1998was preceded by the Chief Executive's Policy Address 1998, members agreed that the meeting should be used for briefing by the Secretary for Health and Welfare on thePolicy Address.

3. The Panel agreed that an additional meeting would be held on19 October 1998 at 10:45 am to further discuss the Review of the CSSA Scheme.

(Post-meeting note - This item was deferred at the request of the Administration and was replaced by a further discussion on the Consultancy Study on Needs of Elderly in Hong Kong for community support and Residential Care Services.)

4. Mr LAW Chi-kwong suggested and the Chairman agreed to follow-up the item on "Rehabilitation and support services for the ex-mental patients" at the meeting scheduled for 19 October 1998 if time permitted.

III.Welfare Services for the Elderly

Portable Comprehensive Social Security Assistance (PCSSA) Scheme

(LC Paper No. CB(2) 231/98-99(01))

5. Dr YEUNG Sum asked whether the elderly beneficiaries of the PCSSA Scheme had encountered any difficulties in receiving medical treatment in Guangdong and what assistance could be made available to them in the event of difficulties. In response, the Chief Social Security Officer (2) (CSSO(2)) said that there were 968 elderly beneficiaries of the Scheme in Guangdong and that in case they could not afford to pay the medical expenses from the PCSSA payment, they could return to Hong Kong for free medical treatment. Hong Kong Red Cross (HKRC), being the agent of the Social Welfare Department (SWD) to help implement the scheme, would arrange escort service for them. On the request of Dr YEUNG Sum, CSSO(2) agreed to provide more information on the medical aspect when the University of Hong Kong (HKU) had completed its evaluative study on the scheme.

Adm

6. In response to Mr Fred LI's request for statistics, CSSO(2) pointed out that it would be difficult to assess the success of the PCSSA Scheme on the sole basis of number of participants. According to the available statistics, 32 elderly beneficiaries had returned to Hong Kong, mainly because of adjustment problem. About one quarter of those elderly beneficiaries were in need of medical treatment and they preferred to receive treatment in Hong Kong. If they were tenants of public housing, they could retain the public housing unit for a three-month grace period. As for home visits, CSSO(2) said that the HKRC had already visited over 10% of the elderly beneficiaries in Guangdong.

7. Miss CHOY So-yuk asked for the reasons why 100 odd applications for the PCSSA were rejected. CSSO(2) answered that of those 100 odd cases, some 20 cases were not eligible for PCSSA because they had not been on the CSSA for three years and that certain applicants changed their mind and withdrew their applications.

8. Upon further enquiry of Miss CHOY So-yuk, CSSO(2) informed that only a few elderly beneficiaries had asked for escort service to return to Hong Kong for medical treatment. They returned to Guangdong within their own resources after the treatment. In cases where living arrangement/ accommodation was a problem, SWD and medical social workers would provide necessary assistance to the elderly beneficiaries as appropriate.

9. Miss CHOY So-yuk was of the view that the HKRC should pay more home visits to the elderly beneficiaries in Guangdong as only 10% of the cases being visited was on the low side. CSSO(2) pointed out that Guangdong was quite a big province but assured members that more visits would be arranged if resources permitted.

10. Mr Fred LI considered that the Administration should allocate more resources for the HKRC to contact and visit more elderly beneficiaries in Guangdong since the PCSSA Scheme with no supplementary special grants had allowed savings for the Government. In response, the Deputy Secretary for Health and Welfare (2) (DSHW(2)) agreed that the HKRC should contact and visit more elderly beneficiaries of the Scheme. However, it would be necessary to further examine whether savings had been made due to the implementation of this Scheme.

11. Members noted that the HKU was conducting an evaluative study on the PCSSA Scheme and that the Administration would undertake a review of the scheme. The Chairman suggested and members agreed that the review should also examine the feasibility of extending the PCSSA Scheme to provinces other than Guangdong.	Adm

Social Networking for the Elderly Project (SNEP)

(LC Paper No. CB(2) 231/98-99(02))

12. Referring to para. 9 of the paper, Mr Fred LI observed that as only 7 073 elderly persons amongst 14 580 vulnerable elderly on the list were matched with volunteers, more than half of the vulnerable elderly were not served although the SNEP had been implemented for two years. The Assistant Director of Social Welfare (Elderly and Medical Social Services)(ADSW(E&MSS)) admitted that this was the situation at the end of July 1998, but pointed out that the elderly persons were classified into priority (i.e. the disabled, the sick, etc.) and non-priority cases in the SNEP and that about 6 200 priority cases were already matched with volunteers. Those non-priority cases had yet to be served mainly because the volunteers preferred to pair up with some other volunteers when undertaking the networking activities, e.g. paying visits to the elderly people at home. Expanding the volunteer network would be further looked into. The District Committees on Social Networking oversaw the project at the district level.

13. On the issue of transport and lunch allowances for the volunteers raised by Mr Fred LI, ADSW(E&MSS) replied that there was no provision for such allowances when the SNEP was planned. However, transport allowance would be granted to the volunteers through the Support Teams for the Elderly to be set up from October 1998.

14. On an enquiry of Mr Fred LI, ADSW(E&MSS) confirmed that the SNEP had become a regular service in the form of Support Teams and would receive recurrent subvention from the SWD.

15. The Chairman asked for the report of the evaluative study of SNEP to be provided to the Panel. ADSW(E&MSS) said that a final report had yet to be received from the HKU by end September 1998 whereas an interim report dated March 1998 confirmed that the project had met its objectives.

16. In response to Dr YEUNG Sum's enquiry, ADSW(E&MSS) clarified that the elderly persons of the SNEP were not clients of other elderly services.

17. As regards the rate of expansion for support teams for the elderly, Mr HO Sai-chu wondered if the planned provision of 36 teams by 2000/01 would be sufficient to meet the demand for the service. In response, ADSW(E&MSS) stated that the rate of expansion would be further studied once more information was made available from the evaluative study of the SNEP. The Deputy Director of Social Welfare (Services) added that the expansion of the support teams for the elderly was planned in conjunction with multi-service centres for the elderly.

18. Mr Fred LI referred to the service statistics in para. 9 and commented that more face-to-face contacts/home visits should be conducted as interviews were conducted only once every two months for each elderly person on the priority list. ADSW(E&MSS) explained that there was manpower constraint as SNEP was manned by volunteers who needed to be trained first. In response to Mr LI's request for more details of the study, ADSW(E&MSS) undertook to provide more information to the Panel in November 1998 after the evaluative study of the SNEP was completed by the HKU.

Adm

Supply of Premises for Residential Care Homes for the Elderly (RCHEs)

(LC Paper No. CB(2) 231/98-99(03))

19. Mr LEE Kai-ming enquired about the progress of the two court cases mentioned in the paper, DSHW(2) advised that the two impending lawsuits were waiting for dates of hearing to be fixed. He said that the deed of mutual convenant (DMC) was a private contract which regulated the rights and obligations among owners of a building. There were usually no specific prohibitions in DMC against the operation of RCHE, but there were routine clauses against contravention of specified land and building usage. Furthermore, provisions against the setting of inns, hotel, guesthouse, etc. in the buildings were also common-place and there were different legal opinions on whether these provisions would debar RCHEs from the building. The Administration was examining the possibility of removing such grey areas in the future DMCs.

20. In response to the Chairman, DSHW(2) clarified that it was not a prevailing government policy to prohibit the operation of RCHE in private housing.

21. In reply to Dr YEUNG Sum, DSHW(2) said that there were about 400 RCHEs in operation in private composite buildings and that the majority of them co-existed peacefully with other residents in the buildings. The Administration, though not in a position to intervene, would try to mediate in case of disputes.

22. In response to a further enquiry of Dr YEUNG Sum, DSHW(2) advised that there were 20 000 cases wait-listed for admission to care and attention (C&A) homes and that about 10 000 cases were estimated to have genuine needs. The provision of 7 100 places in C&A homes in the next two to three years would help shorten the waiting list.

23. Mr LAW Chi-kwong proposed and DSHW(2) agreed that the Administration should consider measures to facilitate the setting up of RCHEs in private housing. DSHW(2) felt that even if the impending lawsuits were adjudicated in favour of the owners incorporations, it did not necessarily follow that there would be more similar lawsuits in future as many RCHEs in private housing were in perfect harmony with their neighbours. In the unlikely event that there were a large number of such court cases threatening the existence of RCHEs in private housing areas, one possibility was to introduce legislative amendment to deal to with the situation, but this would represent very drastic action which the Administration would not contemplate lightly.

24. Mr LEE Kai-ming referred to para. 3(a) and commented that the time taken to lease out vacant premises in government properties and commercial properties in public housing estate was too long. The Chairman pointed out that some of the premises were in rather remote locations. She suggested that some immediately available commercial premises in public housing estates should be leased out first. DSHW(2) explained that the length of time taken to lease out vacant government premises in Shatin to private RCHE operators was because of the unsatisfactory result of the first tendering exercise which made it necessary for a second tendering exercise to be conducted. He had requested the Housing Department to identify more suitable premises for RCHE purpose. Meanwhile, the Director of Social Welfare had been appointed by the Secretary for Health and Welfare to head a Strategic Group to formulate a premise-led programme for RCHEs. The Administration undertook to keep the Panel informed of the progress of the programme in due course.

Adm Adm

25. Mr Ho Sai-chu questioned if the provision of Health Workers (HWs) would be adequate to meet the demand of RCHEs. In response, ADSW(E&MSS) stated that in spite of the 35% wastage rate, about 60% of the trained HWs chose to remain in the industry although not all of them were engaged in private RCHEs. A working group comprising representatives of the SWD, Hospital Authority and the relevant professional bodies was set up to review the training courses as well as to forecast the demand for HWs. Regarding the retention of HWs, the Administration anticipated that on the implementation of the Enhanced Bought Place Scheme, the RCHEs could offer more attractive salaries to HWs and that would help recruit and retain HWs in the industry. The Chairman referred to previous discussion by the Provisional Legislative Council Panel on Welfare Services on the subject and urged that the employment of locals of Care Workers (CWs) should be monitored by the Administration. DSHW(2) informed the Panel that matter had been discussed by the Ad-hoc Committee on Housing and Residential Care of the Elderly Commission. He said that in the short term, it was not possible to stipulate that only locals could be employed but the Administration hoped that a higher salary would be able to attract more locals to take up the job. He assured members that the Administration would monitor the matter. At the request of Mr LEE Cheuk-yan, DSHW(2) agreed to provide a report on the subject.

Consultancy Study on Needs of Elderly in Hong Kong for Community Support and Residential Care Services

(LC Paper No. CB(2) 231/98-99(04))

26. The Principal Assistant Secretary (Elderly Services 1) briefed the Panel on the background, major findings and recommendations of the consultancy study on the needs of elderly people in Hong Kong for residential care and community support services. The study was commissioned on the basis of the recommendations of the 1994 Working Group on Care for the Elderly.

27. Mr LEE Cheuk-yan said that he was dissatisfied with the consultancy report. He considered that the study aimed to save financial resources to be spent on services for the elderly and that the hidden agenda was -

1. to reduce the planning ratio for the elderly services; and

2. to promote the concept of user pays.

28. Deputy Secretary (Health & Welfare)2 rebutted that the allegations were unfounded. The Administration had been allocating substantial amount of resources in the provision of elderly service and the Chief Executive had made a pledge in his 1997 Policy Address to increase significantly the level of service provision for the elderly. However, given the current economic slowdown, it was high time to consider and map a long-term strategy on financing for elderly services. The consultancy study under discussion was conducted to assess the needs of the elderly for services and the long-term implications. The consultants had studied, among other things, the long-term financial requirements for providing service at the level recommended. The consultants pointed out that it would be impossible for the Government to shoulder full costs of the services and had put forward means-testing and user-pay as part of the recommendations. DS(HW)2 explained that the situation was very similar to those in many Western countries as well as in Japan. He quoted for reference the case in Japan where an indirect tax was introduced as one of the means to meet the expenditure for elderly services.

29. In response to Mr LEE Cheuk-yan's comments that the consultancy study was a considered option and a trade-off, DSHW(2) reiterated that the study was conducted to assess the needs of the elderly for services. Objective criteria, viz. the physical and cognitive level of the elderly and the availability of carers, were used to determine the elderly's need for formal care.

30. In rely to Mr Fred LI's question on the methodology applied to obtain results regarding elderly in residential care homes, DS(HW)2 explained that the results regarding elderly in RCHEs were obtained in interviews with nursing and care staff in the homes.

31. Noting that 90% of private RCHEs had not yet obtained licences, Mr Fred LI asked the Administration how it would make sure that bought places in the private RCHEs were up to standard. ADSW(E&MSS) said that there had been progress in the licensing situation and now 18% of the private RCHEs i.e. 77 homes were licensed. Upon the implementation of the Bought Place Scheme, 2 400 places would be purchased over three years, with 600 places to be bought in 1998/99, 800 places to be bought in 1999/2000 and 1 000 places to be bought in 2000/01. ADSW(E&MSS) estimated that by the end of 1998/99, 100 licences would be issued and that another 100 licences would be issued in 1999/2000. She therefore considered that there would be sufficient places of approved quality to meet the requirement. She also assured members that the Administration would try its best to monitor and improve the quality of the homes concerned.

32. Referring to the review of admission criteria to homes for the aged (H/A) in Annex B, Mr Fred LI asked if the Administration would be upgrading the service provision in H/A to the level C&A homes. DS(HW)2 affirmed that the staffing provisions and facilities in H/A would be gradually upgraded to the level of C&A homes. However, the process in existing H/As might take a longer period of time to minimise disturbance to the residents.

33. DS(HW)2 further explained that the review of admission criteria H/As was based on the recommendation put forward in the consultancy study that resources for residential care services should be focused towards elderly with higher level of physical or cognitive impairments. The review aimed to redefine the admission criteria to H/As so that elderly of higher level of frailty would be admitted. Dr YEUNG Sum had reservation about the proposal, as those who were not severely impaired but not capable of self-care would never be admitted. DS(HW)2 explained that, along the line of the consultancy recommendations, elderly with low level or no impairments should be allowed to age in community, with the support of community care services as necessary.

34. Mr LAW Chi-kwong commented that it would be more expensive to keep elderly persons not capable of self-care in the community than in residential care homes because of the need to provide home care and support services. He urged the Administration to avoid fragmentation of support services when planning for support services for the carers of the elderly in order that support services would also be available to the carers of people with disabilities.

35. Mr Fred LI noted that about 20 000 elderly were awaiting C&A place, of whom about 50% met the admission criteria. He enquired how the other 50% of the applicants would be handled. DS(HW)2 explained that according to the latest assessment, about 50% of the elderly on the waiting list had genuine need for residential care services. For those who do not had a genuine need for care services, it would be more appropriate for them to remain at home, with the support of community care services.

36. In view of the significance of the issue concerning service for elderly, the Chairman suggested, and members agreed that the discussions on the consultancy study should be further conducted at a future meeting.

IV.Employment Situation of Social Work Graduates

(LC Paper No. CB(2) 231/98-99(05))

37. Referring to para. 5 of the paper, Dr YEUNG Sum noted that about half of the social work graduates could not secure jobs in the social work field. He asked for an explanation from the Administration on the trend of the problem since Annexes II and III showed that the problem would become less serious starting from 2000/01. DSHW(3) clarified that the two surveys were conducted in 1997 and 1998 respectively. The 1997 survey had a slightly higher response rate and showed that more students had found employment - about 80%. As regards the lower response rate in the 1998 survey, DSHW(3) suggested that the students might be less interested in responding since they had already secured employment with the passage of time. Generally speaking, the overall employment situation for social work graduates, as shown by surveys conducted by University Grants Committee-funded institutions, did not compare unfavourably with the overall situation of graduates in 1997. Looking ahead, DSHW(3) having regard the Social Welfare Manpower Report No. 10, envisaged that in the short term, the employment situation of social work graduates would probably worsen because of the down turn in the local economy.

38. In addition, DSHW(3) pointed out that there were variances between the projected and actual figures on manpower supply and demand because of the many intervening variables. Nevertheless, the Administration would continue to examine the projection methodology with a view to examining ways of improving its accuracy.

39. In response to a question raised by Dr YEUNG Sum, DSHW(3) confirmed that the unemployment problem appeared to be more serious in 1998/99 than in 1997/98 because of a number of factors including the differences between actual and projected number of posts to be created, as indicated at Annex II.

40. Mr Fred LI said that since social work training was more costly than many other professional training courses, it would be a waste of resources when so many social work graduates could not found employment in their field of training. He also asked whether more social work posts could be created, in addition to the 318 new posts earmarked for 1998/99 so that more graduates could be employed. In response, DSHW(3) said that based on the figures available to the Administration and the information provided by the University Grants Committee, it was in fact less costly, to train social scientists (including social workers) than humanities students. As to the creation of additional posts, the resource allocation exercise was conducted annually and decisions taken on the resources to be deployed to individual programs areas in the following year. This prudent financial management practice had served Hong Kong well. In addition to the 318 new social work posts earmarked for 1998/99, he anticipated the creation of other new social work posts in the forthcoming resource allocation exercise, for implementation in 1999/2000.

41. In response to Mr LEE Cheuk-yan's enquiry about the impact on intake of social work students, DSHW(3) said that in view of the present situation and in particular the rapid decline in the wastage rate and slowdown in funded demand, the Administration would discuss with the Education and Manpower Bureau and the University Grants Committee if the feasibility of instituting immediate changes to the future intake of social work students in training institutions in the middle of a triennium cycle.

42. On further enquiry of Mr LEE Cheuk-yan about forecast of demand for social work posts, DSHW(3) said that the demand for the first two years was covered in the Manpower Report, based on actual funded demand. However, for the subsequent three years in the five year period, the demand was only estimated on the basis of the population growth or the shortfall in services which were not planned on the basis of population.

43. Miss Cyd HO asked for the cause leading to the present situation. In response, DSHW(3) said that there was a number of reasons which he had referred to earlier. In addition, it was worth noting that the financial resources committed to social welfare in general had been very substantially increased recently - a three-fold increase over the past five years. At present, social welfare accounted for 12.5% of total government recurrent expenditure, up from 8.3% five years ago.

44. In response to a question raised by Miss Cyd HO and the Chairman regarding whether demand for services matched the supply of graduates, DSHW(3) advised that the Government had to determine priorities and could not meet all demands for services simultaneously even within the social welfare sector.

45. Dr YEUNG Sum considered that the provision of one school social worker to each school, if implemented, would create many more posts in the social work field to help ameliorate the employment problem of social work graduates. In this connection, DSHW(3) informed Members that the financial implications of providing one school social worker in each secondary school would be at least $90 million. This issue was subject of an on-going review by a Working Group under the chairmanship of the SWD.

46. Miss Cyd HO suggested and the Chairman agreed that the Financial Secretary should be provided with this part of the minutes to show that the lack of funds had caused difficulties in the social work field and to urge him to consider allocating more resources to the social welfare sector.	CAS(2)4

47. The meeting ended at 12:58 p.m.

Legislative Council Secretariat
16 October 1998