Motion on “Cross-Boundary Elderly Care” (2018.06.20)

MR CHAN KIN-POR (in Cantonese): President, Hong Kong is facing the problem of an ageing population. People born in the 1950s and 1960s will be approaching their retirement ages. It is thus necessary for us to properly prepare for population ageing. Ageing in place is definitely a better choice and the direction for the allocation of more Government resources than the construction of more residential care homes of the elderly (“RCHEs”), taking into account of the demand for land sites and the manpower supply. However, due to the exorbitant property prices and high living standard, it will barely be affordable for the middle class to enjoy their twilight years in Hong Kong. Life is really not easy for the poor grass-roots people even with subsidies from the Government.

We frequently hear people talking about the hardship of elderly singletons. The living environment of some RCHE residents is also far from satisfactory as quite a number of local RCHEs have come under fire for their poor conditions. I am sure that some elderly persons will be happy to retire on the Mainland if we can provide better environment, more care personnel, and professional support services to them. For those who have kept in contact with compatriots in their hometowns after they moved to Hong Kong at a young age, they will have stronger desire to settle on the Mainland. I think many elderly persons somehow have connections in their hometowns, and they will surely opt to settle on the Mainland after retirement.

So far, a large number of elderly persons have settled on the Mainland after retirement. The Government has also launched a number of initiatives in support of cross-boundary elderly care. With the aids of such schemes as the Guangdong Scheme, the Fujian Scheme, the Pilot Residential Care Services Scheme in Guangdong, and the Portable Comprehensive Social Security Assistance Scheme, many elderly persons have been able to reside on the Mainland after retirement. The number has reached nearly 20 000 now.

In real life, however, there are many difficulties hindering the development of cross-boundary elderly care and discouraging a majority of elderly people from settling on the Mainland. According to analysis, the long distance between Hong Kong and the Mainland is one of the two major worries of elderly persons, making them hesitate to retire on the Mainland. Generally speaking, it will take two to three hours for them to return to Hong Kong from the Mainland. Elderly persons will suffer from greater inconvenience if they need follow-up medical consultations in Hong Kong. Their children may also find it inconvenient to visit them. Another worry is the availability of medical services. Elderly persons are more prone to illnesses. If they are not covered by any medical insurance schemes on the Mainland, they will need to return to Hong Kong for the treatment of illnesses aside regular follow-up consultations. This will be very troublesome. Hence, to promote cross-boundary elderly care, we will first need to overcome these two hurdles.

The development of the Guangdong-Hong Kong-Macao Bay Area (“the Bay Area”) is well underway, while the Hong Kong-Zhuhai-Macao Bridge and the Hong Kong Section of Guangzhou-Shenzhen-Hong Kong Express Rail Link will soon commence operation. The shortened journey time will lessen the worry of elderly persons over the long distance between the two places. This is favourable to the development of cross-boundary elderly care. The second problem we have to deal with is the provision of medical services. Today, we have proposed ways to improve the medical services for elderly persons residing on the Mainland in the original motion and some amendments to the motion. There are calls for extending the scope of application of Hong Kong’s Health Care Vouchers (“HCVs”) to cover major hospitals and clinics on the Mainland; allowing for the transfer of medical records of elderly persons who have moved to the Mainland to Mainland hospitals; and taking out Urban Resident Basic Medical Insurance for elderly persons who have moved to the Mainland. These proposals are worth our consideration. At present, Hong Kong elderly persons can basically use HCVs in the University of Hong Kong-Shenzhen Hospital, and this approach is proven to be feasible. Hence, the Government should consider further extending the scope of application of HCVs to cover large-scale medical institutions on the Mainland. I trust the Government will discuss the cooperation plan on the use of HCVs with Mainland hospitals in due course. Hopefully, elderly persons can use their HCVs on the Mainland in the near future.

Besides, the residence rule under the Old Age Living Allowance (“OALA”) has made it difficult for some 400 000 elderly persons to opt for cross-boundary retirement. I think the Government should make reference to the Guangdong Scheme and relax the residence rule to allow OALA recipients to move to the Mainland. As the amounts of allowance under OALA are higher than those under the Guangdong Scheme, OALA recipients should be able to cope with their retirement life on the Mainland. With the provision of proper medical support, I believe more elderly persons are willing to retire on the Mainland.

Indeed, apart from the grass roots, many middle-class elderly persons are also interested in cross-boundary elderly care services to enjoy quality services and good environment at more affordable costs. Modelling on their overseas counterparts, some Mainland RCHEs not only offer high-quality services as well as better environment and facilities, but they also provide basic medical support services, making them considerably attractive to middle-class elderly. However, without any Government subsidy, middle-class elderly in Hong Kong may feel worried about the long-term financial pressure of living in the quality Mainland RCHEs. I have time and again called on the Government to make better use of the insurance-based model to help address the problem of population ageing. Some examples are the Voluntary Health Insurance Scheme, the Mandatory Provident Fund Schemes, and the HKMC Annuity Plan. An insurance-based scheme may be helpful to address the cross-boundary care need of middle-class elderly.

Recently, the insurance industry has proactively examined the development prospect in the Bay Area. I have received a proposal from the industry which advocates the development of cross-boundary insurance products for seniors to further facilitate Hong Kong elderly persons to retire on the Mainland. The proposal also calls on the insurance industry to engage in discussion with Governments of the two places, encourage insurers to participate and invest in the development of elderly facilities in the Bay Area to build quality RCHEs there, and to provide insurance products for seniors. The proposal is preliminary and its feasibility requires further studies. Yet, I find the proposal very constructive and conducive to the achievement of an all-win situation: the development of a new model of cross-boundary elderly care for the middle-class; the provision of a solution to population ageing in society; the exploration of a new development direction for the insurance industry, and the forging of a sound cooperation model for the Bay Area development. I have asked the Hong Kong Federation of Insurers to thoroughly study the feasibility of the proposal for further discussion with the Government. I hope that when the concrete proposal is in place, it can obtain expeditious approval from Governments of the two places to let the public benefit from it as soon as possible.

Thank you, President. I so submit.

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