1 HONG KONG LEGISLATIVE COUNCIL -- 20 November 1991 HONG KONG LEGISLATIVE COUNCIL -- 20 November 1991 1
OFFICIAL RECORD OF PROCEEDINGS
Wednesday, 20 November 1991
The Council met at half-past Two o'clock
PRESENT
THE DEPUTY PRESIDENT
THE HONOURABLE JOHN JOSEPH SWAINE, C.B.E., Q.C., J.P.
THE CHIEF SECRETARY
THE HONOURABLE SIR DAVID ROBERT FORD, K.B.E., L.V.O., J.P.
THE FINANCIAL SECRETARY
THE HONOURABLE DAVID ALAN CHALLONER NENDICK, C.B.E., J.P.
THE ATTORNEY GENERAL
THE HONOURABLE JEREMY FELL MATHEWS, C.M.G., J.P. THE HONOURABLE ALLEN LEE PENG-FEI, C.B.E., J.P. THE HONOURABLE STEPHEN CHEONG KAM-CHUEN, C.B.E., J.P. THE HONOURABLE MRS SELINA CHOW LIANG SHUK-YEE, O.B.E., J.P. THE HONOURABLE MRS RITA FAN HSU LAI-TAI, O.B.E., J.P. THE HONOURABLE HUI YIN-FAT, O.B.E., J.P.
THE HONOURABLE MARTIN LEE CHU-MING, Q.C., J.P. THE HONOURABLE DAVID LI KWOK-PO, O.B.E., J.P. THE HONOURABLE NGAI SHIU-KIT, O.B.E., J.P. THE HONOURABLE PANG CHUN-HOI, M.B.E.
THE HONOURABLE TAM YIU-CHUNG
THE HONOURABLE ANDREW WONG WANG-FAT, O.B.E., J.P. THE HONOURABLE LAU WONG-FAT, O.B.E., J.P.
THE HONOURABLE EDWARD HO SING-TIN, J.P.
THE HONOURABLE RONALD JOSEPH ARCULLI, J.P.
THE HONOURABLE MARTIN GILBERT BARROW, O.B.E., J.P. THE HONOURABLE MRS PEGGY LAM, M.B.E., J.P.
THE HONOURABLE MRS MIRIAM LAU KIN-YEE, J.P. DR THE HONOURABLE LEONG CHE-HUNG
THE HONOURABLE JAMES DAVID McGREGOR, O.B.E., I.S.O., J.P. THE HONOURABLE MRS ELSIE TU, C.B.E.
THE HONOURABLE PETER WONG HONG-YUEN, J.P.
THE HONOURABLE ALBERT CHAN WAI-YIP
PROF THE HONOURABLE EDWARD CHEN KWAN-YIU
THE HONOURABLE VINCENT CHENG HOI-CHUEN
THE HONOURABLE MOSES CHENG MO-CHI
THE HONOURABLE MARVIN CHEUNG KIN-TUNG, J.P. THE HONOURABLE CHEUNG MAN-KWONG
THE HONOURABLE CHIM PUI-CHUNG
REV THE HONOURABLE FUNG CHI-WOOD
THE HONOURABLE FREDERICK FUNG KIN-KEE THE HONOURABLE TIMOTHY HA WING-HO, M.B.E., J.P. THE HONOURABLE MICHAEL HO MUN-KA
DR THE HONOURABLE HUANG CHEN-YA
THE HONOURABLE SIMON IP SIK-ON, J.P. DR THE HONOURABLE LAM KUI-CHUN
DR THE HONOURABLE CONRAD LAM KUI-SHING THE HONOURABLE LAU CHIN-SHEK
THE HONOURABLE MISS EMILY LAU WAI-HING THE HONOURABLE LEE WING-TAT
THE HONOURABLE GILBERT LEUNG KAM-HO
THE HONOURABLE ERIC LI KA-CHEUNG, J.P. THE HONOURABLE FRED LI WAH-MING
THE HONOURALBE MAN SAI-CHEONG
THE HONOURABLE NG MING-YUM
THE HONOURABLE STEVEN POON KWOK-LIM
THE HONOURABLE TIK CHI-YUEN
THE HONOURABLE JAMES TO KUN-SUN
DR THE HONOURABLE SAMUEL WONG PING-WAI, M.B.E., J.P. DR THE HONOURABLE PHILIP WONG YU-HONG
DR THE HONOURABLE YEUNG SUM
THE HONOURABLE HOWARD YOUNG
ABSENT
THE HONOURABLE SZETO WAH
THE HONOURABLE LAU WAH-SUM, O.B.E., J.P. PROF THE HONOURABLE FELICE LIEH MAK, O.B.E., J.P. THE HONOURABLE HENRY TANG YING-YEN, J.P.
IN ATTENDANCE
MR GRAHAM BARNES, C.B.E., J.P.
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS
MRS ANSON CHAN, J.P.
SECRETARY FOR ECONOMIC SERVICES
MR YEUNG KAI-YIN, J.P.
SECRETARY FOR THE TREASURY
MR JOHN CHAN CHO-CHAK, L.V.O., O.B.E., J.P. SECRETARY FOR EDUCATION AND MANPOWER
MR ALISTAIR PETER ASPREY, O.B.E., A.E., J.P. SECRETARY FOR SECURITY
MRS ELIZABETH WONG CHIEN CHI-LIEN, I.S.O., J.P. SECRETARY FOR HEALTH AND WELFARE
MR CHAU TAK-HAY, J.P.
SECRETARY FOR TRADE AND INDUSTRY
THE CLERK TO THE LEGISLATIVE COUNCIL MR LAW KAM-SANG
Papers
The following papers were laid on the table pursuant to Standing Order 14(2): Subject
Subsidiary Legislation L.N. No.
Banking Ordinance (Amendment of Third Schedule)
(No. 2) Notice 1991.................................................. 407/91
Declaration of Change of Titles (Chief Architect of
Division 3 of the Architectural Office of the
Public Works Department and Chief Architect of
Division 3 of the Architectural Office of the
Building Development Department) Notice 1991......... 408/91
Statutes of the Chinese University of Hong Kong
(Amendment) (No. 3) Statutes 1991........................... 409/91
Electricity Ordinance 1990 (Commencement of
Section 33) Notice 1991............................................
410/91
Electricity (Registration) Regulations 1990
(Commencement of Regulation 3) Notice 1991............ 411/91
Hong Kong War Memorial Pensions Ordinance 1991
(Commencement) (No. 2) Notice 1991....................... 412/91
Town Planning (Amendment) (No. 2) Ordinance
1991 (Commencement) Notice 1991........................... 413/91
Sessional Paper 1991-92
No. 18 -- The Prince Philip Dental Hospital Hong Kong
Report by the Board of Governors for the period
1 April 1990 - 31 March 1991
No. 19 -- Annual Report of the Director of Accounting
Services and the Accounts of Hong Kong for the
year ended 31 March 1991
No. 20 -- Report of the Director of Audit on the Accounts of the Hong Kong Government for the
year ended 31 March 1991 and the results of
value for money audits October 1991
Director of Audit's Report No. 17
Oral answers to questions
Water pollution
1. MR VINCENT CHENG asked: As Victoria Harbour will not be declared as a water control zone before 1993, that is, two years behind the original schedule, will Government inform this Council:
(a) what measures are being taken to prevent factories from discharging polluted waste water into the harbour;
(b) what actions are being taken to investigate and prevent the illegal connection of residential, industrial and commercial waste water outlets to stormwater drains;
(c) how many offenders have been prosecuted in the last 12 months for illegally dumping refuse into the harbour; and
(d) whether there has been deterioration in the water quality of the harbour during the past two years?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, may I take the first two questions together. A variety of measures are in hand; these measures are centred on our territory-wide programme of Sewerage Masterplans. The measures are,
(i) firstly, on the planning front, priority has been given to the territory-wide Sewerage Masterplans programme to those areas where industrial discharges are being made directly into the harbour. Measures against illegal connections to stormwater drains are included in these Masterplans, which investigate the extent, capacity and physical state of the existing sewerage system including the numbers of unauthorized connections, and propose measures to meet the existing and future demands for new sewerage. The harbour is covered by seven such Sewerage Masterplans and studies for four of these have been completed or are underway. The masterplans also identify "first aid measures" that can provide short-term improvements to some pollution
blackspots.
(ii) Secondly, on the construction front, there are already several ongoing and proposed regional sewerage improvement schemes around the harbour: most of which arise from the masterplanning strategy that I have just mentioned. These are,
-- the Northwest Kowloon Sewerage Treatment and Disposal Scheme, which will be completed in 1992 at a cost of $1.3 billion. This system will remove the three existing outfalls which presently discharge sewage and industrial effluents into the harbour and divert to a treatment facility on Stonecutters Island. In addition to this major scheme, which should create a large measure of improvement in the areas concerned, a masterplan has been developed to comprehensively upgrade local sewerage, the first phase of which will be carried out in parallel with works under the West Kowloon Reclamation;
-- the East Kowloon Scheme, which started this month, Stage I of which will be completed in 1994 at a cost of $550 million. This system will provide trunk sewers to intercept industrial effluent presently discharging into Kowloon Bay typhoon shelter and will provide sewerage large enough to accommodate all present and future flows in the East Kowloon area. The second phase, which is planned to be completed by 1996 at a cost of some $460 million, will provide for local resewerage and removal of expedient connections, that is, connections into stormwater drains;
-- the Tsuen Wan/Kwai Tsing Sewerage Scheme; this is a two year project which will commence in 1992 and it will cost about $182 million. It is for the provision of new and upgraded sections of trunk sewers at Kwai Chung and associated local sewerage. This project will provide adequate capacity to accommodate the domestic and industrial flows generated in the area, much of which presently discharges to the stormwater drains. The second phase, at an estimated cost of $200 million, is planned to start in 1993 and will provide improved trunk sewerage to Tsuen Wan;
-- Sham Tseng Sewerage and Sewage Treatment and Disposal Facilities. This provides, at a cost of about $140 million, an interceptor sewer and a sewage treatment works at Sham Tseng.
(iii) As regards controls, enforcement action under the Buildings Ordinance against illegal and polluting drains is carried out by a specialized task force set up in the Buildings Ordinance Office in 1986. It maintains close liaison with the Environmental Protection Department and tackles serious cases referred to it by the Department. Significant improvement has been achieved in particular at Sha Tin, Tuen Mun and Kwai Tsing. These exercises are sometimes assisted by Industrial Building Management Co-ordinating Committees set up by the district boards. Another measure, an effective cradle-to-grave scheme for the control of chemical wastes is being
formulated, and we would introduce this scheme in 1992 so it can be in action before the Chemical Waste Treatment Facility is commissioned at the end of 1992. Referring to the third part -- about offenders -- of Mr CHENG's question, during the last 12 months from November 1990 to the end of October this year, there were 73 prosecutions under the Dumping at Sea Act for illegal dumping activities, and 80 prosecutions under the Summary Offences Ordinance for minor littering offences.
And lastly, about the water quality, the water quality has been consistently bad in the harbour in the last two years. There has not however been significant
deterioration in that period. Dissolved oxygen has been above 50% which is about the lowest tolerable level for marine life. The distribution of bacteria E Coli varies very widely, but in some places, and that is the worst places, there have been readings as high as 10 000 parts per l00 ml.
MR VINCENT CHENG: Mr Deputy President, can the Secretary inform this Council how many people are employed in the task force for enforcement action, and what the exact percentage of dissolved oxygen is; is it just about 50% for example, or is it 90%?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, I am afraid I cannot now provide Mr CHENG with the figure of how many people are employed in enforcement; they are in various departments. I will assuredly provide him with the figure and the breakdown. (Annex I) Regarding the second part of his question, as I said in my main answer, the distribution of bacteria E Coli does vary very widely in the harbour from tolerable -- for the purposes of water sports which is probably a level of around 600 parts per l00 ml -- to the very extreme figure that I quoted, most readings of which are taken in typhoon shelters.
MR PETER WONG: Mr Deputy President, the Secretary has given a very detailed answer but I would like to put a very simple question to him and that is, when will we see a reversal of the level of pollution in Victoria Harbour?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, it would be hard to give a date. It is dependent really on the progressive works in the sewage disposal strategy. Each of the works which I mentioned will provide improvement in the harbour in a local sense and different parts of the harbour will be benefited. So in a general sense one could say improvements will be starting from 1992 when the first of those works is over. But the main improvement in the harbour sewerage will be when more of the masterplans are completed, which of course depends upon the initiation of a formal sewerage strategy. And of course at the different stages of the sewerage strategy, very significant improvements are made in steps.
DR SAMUEL WONG: Mr Deputy President, could the Secretary for Planning, Environment
and Lands inform this Council whether the considerable quantity of used lubricant oil from motor vehicles currently discharged to nearby drains will be included in the workload of the chemical treatment plant he mentioned?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, to my knowledge, oil from discharge is not in fact a chemical, though there is in fact an oil disposal unit in the chemical waste treatment plant. Although this has been provided primarily, I think, with shipping in mind, it does allow for the possibility for development of the law to prevent the discharge of oil into sewers.
MISS EMILY LAU (in Cantonese): Mr Deputy President, can the Secretary inform this Council of the maximum penalty imposed among the 73 prosecutions for dumping refuse into the harbour during the last 12 months? Will the Administration agree that heavier penalties will have a deterrent effect?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, I understand that the fines are not nearly reaching the present level which was amended in 1989 in the Summary Offences Ordinance; the level is presently at $50,000. But I understand that no fine has exceeded $20,000. I would like to confirm that to Miss LAU in writing; I can confirm it as a generalization but the precise figure I would need to confirm later. (Annex II) But with that in mind, our problem has as yet not been the maximum fine having been set too low, in that we have not got really near the maximum fine in any of the cases we have taken. So although it is time to do a further review of fines which need to be kept up to date every year, I do not know that raising the level of the fine would make a significant difference to the awards that would be made at present.
MRS PEGGY LAM (in Cantonese): Mr Deputy President, four of the seven Sewerage Masterplans mentioned in the Secretary's reply are underway. Which parts of the harbour then will the remaining three masterplans cover? When will they start and how much will they cost?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, there are three
remaining programmes: a programme for Hong Kong North, a programme for further programmes in Kowloon, and further programmes in Tsuen Wan. The remaining masterplans are worth something like $2.2 billion.
MR ALBERT CHAN (in Cantonese): Mr Deputy President, the Secretary mentioned in his reply a number of sewage disposal schemes that would cost hundreds of millions dollars. Can the Administration inform this Council whether it will make a commitment that these projects will be financed through the capital works funds?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: I do not know, Mr Deputy President. I am not in a position to make that commitment. I am indeed at present looking for other means by which to finance it in view of the extreme pressures on capital works funds available for public works in Hong Kong.
Sales tax
2. MR HOWARD YOUNG asked: Will Government inform this Council whether it is aware of the public's objections to the introduction of a sales tax, on the grounds that it would not only do harm to the tourism industry and other tourism-related businesses, but also hit the man in the street at a time of high inflation, and if so, how it plans to ensure that these opinions will be taken into full account before any
decisions to implement such a tax are taken?
SECRETARY FOR THE TREASURY: Mr Deputy President, the Government is fully aware of the community's sensitivity to the possible introduction of a sales tax at a time of high inflation. We have carefully monitored both public opinion and the views of financial experts on this subject.
The problem that the sales tax idea was intended to tackle is that our present tax base is too narrowly based. For example, about 8% of salaries taxpayers now contribute 56% of all salaries tax revenue. As regards profits tax, about one-third is contributed by less than 0.1% of Hong Kong's businesses. This situation leaves us uncomfortably vulnerable to the effect of any downturn in our economy. It also leaves us with insufficiently secure sources of revenue, at a time when there are
important and competing calls on the public purse.
That said, we do not believe that now -- a time of high inflation -- is the time to introduce a sales tax. I can also say that we fully accept that before making a decision on this issue at some future date, we would need to take into account the views of the public, and the need to gain the support of Members of this Council.
MR HOWARD YOUNG: Mr Deputy President, the reply just now mentioned twice that inflation was the reason for not implementing a sales tax at this point in time. However, I would like to ask whether the Government has received an opinion from the tourism industry which points out that inflation is not the only reason; the reason is that it would be particularly damaging to the tourism industry and affect the livelihood of more than 100 000 people in the industry whose income depends on half of the $39 billion spent by tourists in Hong Kong, based on the reputation of us being a "shopper's paradise".
SECRETARY FOR THE TREASURY: Mr Deputy President, I mentioned inflation not with a view to excluding other factors or other considerations affecting the rest of the economy of which tourism is only one, albeit an important one. Yes, we will take the views of various industries and various sectors of the economy fully into account.
MR MARTIN BARROW: Mr Deputy President, is the Secretary aware of a recent study by Dr HALL of the University of Hong Kong which demonstrates that the revenue flow from a sales tax may be no more stable than from other forms of taxation, and is the Secretary going to take that point into consideration in reviewing the matter further?
SECRETARY FOR THE TREASURY: Mr Deputy President, my Branch has taken that study into account. The findings of that study are debatable; the experience of quite a few tax administrations elsewhere suggests that revenue sources based on sales, or indeed consumption, tend to fluctuate in a less volatile way than those from direct taxation which has a very close relationship with general economic performance. But that study will of course be further taken into account.
MR TIK CHI-YUEN (in Cantonese): Mr Deputy President, in 1989 when a consultative document on the introduction of a sales tax was prepared by the Government for limited consultation, some political organizations like the Meeting Point requested a copy but were refused. Just now the Secretary has mentioned that the public will be
consulted if this issue is to be further considered. May I know what organizations and people will be consulted and whether political organizations will be consulted as well?
SECRETARY FOR THE TREASURY: Mr Deputy President, the consultative document that Mr TIK referred to was given very restricted circulation and then confined to a number of experts, and this was prepared by the Commissioner of Inland Revenue. It is not a consultative document issued by the Government because at that stage we had not decided to consult extensively. As to whether we will consult any political or
accounting or business organizations should the Government decide to introduce a measure of this kind, my own guess is that we will consult extensively and there is a strong probability that if we should proceed, we will issue some form of overall consultative document.
DR CONRAD LAM (in Cantonese): Mr Deputy President, as a sales tax will affect the low-income people more than the well-off, can the Secretary inform us whether the Administration will consider introducing a capital gains tax and increasing profits tax before deciding to bring in a sales tax?
SECRETARY FOR THE TREASURY: Mr Deputy President, that question presupposes that if we were to introduce a sales tax we would apply a uniform rate and that therefore the poor would be affected more than the rich. That assumption has to stand the test of policy examination and may not necessarily be true. We are of course now entering into the realm of hypothesis but I would imagine that it would be difficult to replace various differential ad valorum forms of duty, for example on luxuries which affect the big spender more than the poor. That is the answer to the first part of the question.
With regard to the second part of the question, I think we need to draw a clear distinction between corporation profits tax, which is a form of direct taxation, and a sales or consumption tax, which is an indirect form of taxation. Given that we are at the moment already over-dependent on direct sources of taxation, I would
imagine that to try to raise the poundage of profits tax ahead of the introduction
of a sales tax would make our revenue perhaps even more dependent on direct taxation and therefore more vulnerable to the vagaries of economic performance. So the answer to that particular part of the question is no. The Government has not, Mr Deputy President, taken a view on capital gains tax. It is a new idea altogether; we have not even begun to think about it.
MR TAM YIU-CHUNG (in Cantonese): Mr Deputy President, would the Government consider the figures and ratios given in the second paragraph of the Secretary's reply as indicative of the extreme disparity between the rich and the poor?
SECRETARY FOR THE TREASURY: Mr Deputy President, these figures were designed to show how narrowly based our tax base is; they are not designed to indicate the distribution of wealth, for which I believe the economists have a device. I am not an expert on the subject and of course I will consult the Secretary for Economic Services for advice,
but I do believe, having heard of this mechanism for calculating the distribution of wealth, that Hong Kong out-performs quite a few territories.
MR STEPHEN CHEONG: Mr Deputy President, in his answer to Dr LAM's supplementary question, the Secretary for the Treasury has said that the Government has not thought about capital gains tax. Will Government consider, in deliberating whether to introduce a capital gains tax, the macro-economic benefit to Hong Kong of not having a capital gains tax?
SECRETARY FOR THE TREASURY: Mr Deputy President, certainly.
REV FUNG CHI-WOOD (in Cantonese): Mr Deputy President, the Secretary's reply seems to suggest that a sales tax will have to be introduced when there is a downturn in our economy and a strong demand for public money. This is done, it appears, for the purpose of generating revenue. But in fact other than the introduction of a sales tax, there are many other alternatives to raise revenue such as increasing profits tax. So why does the Government not consider the other sources of taxation?
SECRETARY FOR THE TREASURY: Mr Deputy President, I believe I have already answered
that question. We have to distinguish between different forms of taxation -- direct taxation and indirect taxation. Profits tax belongs to direct taxation and it is a fact of life, believe it or not, that direct taxation fluctuates very much in relation to the growth performance of the economy, whereas revenue from indirect taxation is less volatile than direct taxation in this respect. That said, I mentioned a while earlier that our sources of revenue are already very heavily dependent on direct taxation, that is to say salaries tax, profits tax and so on; therefore to raise the poundage of profits tax, while feasible, may tip our dependence on direct taxation even further.
MR PETER WONG: Mr Deputy President, can the Secretary please tell us, apart from sales tax, exactly what other avenues the Administration has explored in order to stabilize our tax base?
SECRETARY FOR THE TREASURY: Mr Deputy President, I feel I need notice of that question but I am sure it must have occurred to Mr WONG that other forms of indirect taxation could be explored; rates would be an example.
DEPUTY PRESIDENT: Do you wish to pursue that and ask for a reply in writing, Mr WONG? MR PETER WONG: Mr Deputy President, I would.
SECRETARY FOR THE TREASURY: Mr Deputy President, I shall provide an answer in writing. (Annex III)
Use of handcuffs and handcuff transport belts
3. DR CONRAD LAM asked (in Cantonese): Will the Government inform this Council:
(a) what guidelines are used by the police in considering the use of handcuffs and a handcuff transport belt on a suspect under escort; and
(b) what remedies are open to a suspect if the police have abused their power in the use of handcuffs and handcuff transport belt on him?
SECRETARY FOR SECURITY: Mr Deputy President, the police have detailed internal orders governing the use of handcuffs and handcuff transport belts.
Officers are instructed not to use handcuffs unless necessary, for example where an arrested person is violent, or likely to become violent, or likely to attempt escape. A police officer has to make a judgement himself whether handcuffs are to be used.
The use of handcuff transport belts has to be authorized by the Duty Officer at a police station or an officer of the rank of Sergeant or above. They are used for prisoners or arrested persons who are likely to become violent or to attempt escape, or who are being moved through unsecured areas of a court.
Any complaint against the police about the misuse of handcuffs or handcuff transport belts can be made to the Complaints Against Police Office (CAPO). CAPO will investigate and make recommendations, which will be reviewed by the Police Complaints Committee.
If it can be established that police officers used excessive or unnecessary force whilst arresting him, an arrested person may be able to claim damages against the police.
DR CONRAD LAM (in Cantonese): Mr Deputy President, could the Secretary inform this Council if there were many cases of escape of suspects under escort in the past three years? How many of them, in percentage, were due to the police failing to use handcuffs or handcuff transport belts?
SECRETARY FOR SECURITY: Mr Deputy President, in 1988 there were 16 escapes from police custody, in 1989, 19 escapes, and in 1990, 12 such escapes. I do not have a further breakdown of these figures and I do not think one could be made available.
MR SIMON IP: Mr Deputy President, I can understand why restraining devices should be applied when somebody is violent or somebody is attempting to escape. But I cannot quite understand why a handcuff transport belt should be applied to somebody just because he is being moved through the unsecured areas of a court. Could the Secretary for Security please explain?
SECRETARY FOR SECURITY: Mr Deputy President, the police have a responsibility to keep in custody prisoners and arrested persons and they must take the appropriate steps to ensure that they do not escape.
MRS MIRIAM LAU: Mr Deputy President, can the Secretary inform this Council how many complaints regarding misuse of handcuffs or handcuff transport belts have been made to the Complaints Against Police Office over the last three years and how many of such cases have been found to be substantiated?
SECRETARY FOR SECURITY: Mr Deputy President, there were 22 complaints about the use of handcuffs or handcuff transport belts in 1989, 35 in 1990, and 20 in 1991. Without a great deal of research it is not possible, I am afraid, to ascertain the number of complaints which were substantiated and the disciplinary action taken in
individual cases.
MR CHEUNG MAN-KWONG (in Cantonese): Mr Deputy President, could the Secretary inform this Council if the internal orders of the police specify when handcuffs or handcuff transport belts should be used? If not, with the question arising from the use of handcuffs in mind, will the Administration formulate rules in clear terms and provide the interpretations so that officers on duty may have some guidelines to follow and in this way abuse of power by individual officers and even violation of human rights can be prevented?
SECRETARY FOR SECURITY: Mr Deputy President, I believe that the police internal orders are very clear. Perhaps to give Members some examples of this, they specify that
a police officer shall not use handcuffs on a person unless this is clearly necessary; they make it very clear that the use of handcuffs constitutes a degree of force which must never be applied punitively; they lay down the circumstances in which handcuffs and handcuff transport belts are to be used; they provide that supervisory officers must carry out regular checks to ensure that there is no indiscriminate use of such handcuffs. In the final analysis, whether handcuffs or handcuff transport belts are used has to depend upon the judgment of an individual police officer. And sometimes of course people make wrong judgments.
MR RONALD ARCULLI: Mr Deputy President, in the fourth paragraph of his reply the Secretary has informed this Council that CAPO would look into complaints, if one is made. Would he perhaps inform Members of this Council whether the police would initiate an inquiry without a complaint, in circumstances where it appears that excessive use of handcuffs, or indeed a handcuff transport belt, was unnecessary? And if not, why not?
SECRETARY FOR SECURITY: Yes, Mr Deputy President. If it came to the police's notice otherwise than by a formal complaint to CAPO that there may have been some misuse of handcuffs or handcuff transport belts, or some failure to follow the guidelines, then the police would of their own initiative institute an investigation.
MRS ELSIE TU: Mr Deputy President, again referring to the fourth paragraph of the Secretary's reply, since complaints to CAPO usually take about a year to investigate and are usually found to be unsubstantiated, what other recourse does a complainant have against abuse of police power?
SECRETARY FOR SECURITY: Mr Deputy President, I can only refer Mrs TU to my main answer. I believe in fact that the Complaints Against Police Office procedure is very effective in investigating complaints.
MISS EMILY LAU (in Cantonese): Mr Deputy President, could the Secretary inform this Council if it is necessary for a police officer to inform a suspect of his rights on arresting or taking him into custody so that he is aware of his right to complain
to the authority concerned if there is abuse of police power?
SECRETARY FOR SECURITY: Mr Deputy President, I hesitate to get into this area because I think it is a matter for lawyers. I believe that there are Judge's Rules which clearly lay down what warnings must be given to arrested persons.
DEPUTY PRESIDENT: Could you supply a better answer, Secretary for Security, upon mature consideration, to Miss LAU's question, in writing?
SECRETARY FOR SECURITY: Yes, I will try to, Mr Deputy President. (Annex IV)
MR NG MING-YUM (in Cantonese): Mr Deputy President, referring to an earlier incident of a lawyer whose qualification was queried, it is a case where the police misuse the handcuff transport belt .....
DEPUTY PRESIDENT: I am sorry, Mr NG, but Standing Orders preclude either the naming of persons or of incidents where possible proceedings may be prejudiced. Would you like to reflect on that and determine whether you wish to continue or rephrase your question?
MR NG MING-YUM (in Cantonese): Mr Deputy President, perhaps you will find that I am not at all biased when I have finished my question. In connection with the misuse of handcuff transport belt by the police on the person in question, I had queried the police and was given a written reply by the Commissioner of Police wherein he admitted their fault. Will the Administration inform this Council if disciplinary action was taken against the police officer at fault? If not, why not? If yes, what was the disciplinary action taken?
DEPUTY PRESIDENT: I have to rule your question out of order, Mr NG, because there may be pending proceedings. We know the personality involved and Standing Orders would preclude your pressing that question.
Written answers to questions
Secondary Six Admission Procedure
4. MR NG MING-YUM asked: In view of the introduction of the new "Secondary Six Admission Procedure" by the Education Department in this school year, will the Government inform this Council:
(a) what the situation is in government and subsidized schools as at the end of October this year with regard to the types of Secondary VI classes available, the number of Secondary VI places provided, the actual number of Secondary VI students enrolled, the number of Secondary VI students who have dropped out, and the number of such dropouts who have eventually been enrolled at post-secondary school; and how these figures compare with the corresponding data in the past 10 years;
(b) what the justifications and policy objectives of implementing the new procedure are and what shortcomings have been found in the old system;
(c) whether the Government has conducted any review of the new procedure; if so, what its detailed findings are; if not, when a review will be carried out; and
(d) whether the Government would consider taking effective measures to remedy any shortcomings identified in the new procedure; if so, what are the details of these measures?
SECRETARY FOR EDUCATION AND MANPOWER: Mr Deputy President, the answers to sub paragraph (a) of Mr NG's question are as follows:
(i) The types and numbers of Secondary VI (S6) places available in Government and aided secondary schools as at the end of October 1991 were:
Type No. of classes No. of places
Advanced Level (A-level) 591 17 720
Higher Level (H-level) 56 1 680
----- --------
Total 647 19 400
=== =====
(ii) The actual numbers of Secondary VI students enrolled were:
As at As at
early September 1991 end October 1991
A-level 17 891 17 337
H-level 1 680 1 579
-------- --------
Total 19 571 18 916
===== =====
The over-enrolment in A-level classes as at early September indicates that some schools had recruited more than 30 pupils per class.
(iii) The numbers who have dropped out, as well as new recruits to S6, since early September are:
Net reduction
Dropouts New recruits in enrolment
A-level 682 128 554
H-level 117 16 101
----- ----- -----
Total 799 144 655
=== === ===
Students are not obliged to give reasons for their departure from S6. No comprehensive record of the causes and whereabouts of the "dropouts" from S6 has therefore been kept, and the number of S6 "dropouts" who eventually enrolled in a post-secondary institution is not available.
(iv) Corresponding data on the provision for, and enrolment of, S6 students in public sector secondary schools as at September each year are available only for the past six years. They are:
Provision of Enrolment
Year S6 places Enrolment ratio
1985 16 953 14 771 87.1%
1986 17 363 14 694 84.6%
1987 17 788 14 867 83.6%
1988 17 880 14 756 82.5%
1989 18 225 14 432 79.2%
1990 18 230 15 493 85.0%
As regards sub-paragraph (b) of the question, under-enrolment in public sector schools is wasteful of public sector resources and should be avoided as far as possible. The two main causes of under-enrolment at S6 level have been the highly selective admission policy adopted by many schools and the practice of many well-qualified candidates to apply successfully for admission to more than one school. These have resulted in the situation where some eligible students find themselves without an S6 place at the beginning of a school year, while vacancies exist in other schools, created by students having enrolled but not taking up the places. The new admission procedure aims to tackle these problems, with the ultimate policy objective of maximizing utilization of S6 places in the public sector and producing as many matriculants as possible. It does so by ensuring that eligible students have first priority for the S6 places in their own school. It puts an end to the practice of individual better qualified students securing S6 places in several different schools. It also minimizes the need for S5 leavers to shop around for a place. The results show that places were fully taken up as at early September 1991. Although the enrolment ratio subsequently dropped from 100% to 97.5% by the end of October 1991, it remains the highest for the past seven years.
As regards sub paragraphs (c) and (d) of the question, the Education Department is at present conducting a review of the new Sixth Form admission procedure. If any shortcomings are identified, improvements will be considered for introduction at the beginning of the next school year.
BN(O) and BDTC passports
5. MRS RITA FAN asked: Will the Government inform this Council (a) which countries have waived entry visa requirements for holders of the
following passports:
(i) British National (Overseas) passports;
(ii) British Dependent Territories Citizen passports;
(b) what efforts have been or are being made by the Hong Kong Government to persuade more countries to waive visa requirements for BN(O) passport holders;
(c) whether it is aware that similar efforts have been or are being made by Her Majesty's Government; and
(d) what are the difficulties encountered?
SECRETARY FOR SECURITY: Mr Deputy President, a total of 72 countries/territories allow visa-free visits to Hong Kong residents holding either Hong Kong British Dependent Territories Citizen passports or British National (Overseas) passports. A list of these countries/territories is attached. A further two countries, Austria and Mauritius, allow visa-free access to BDTC passport holders, but require visas for BN(O) passport holders.
Since the time when Austria and Mauritius imposed a visa requirement on BN(O) passport holders, Her Majesty's Government at our request has been trying to persuade Austria and Mauritius to waive visa requirements for BN(O) passport holders in the same way as for BDTC passport holders. Efforts are continuing. The Foreign and
Commonwealth Office at our request is also making efforts to persuade other countries to waive their visa requirements. A visa waiver agreement with Poland, which will allow both BDTC and BN(O) passport holders to enter Poland for seven days without visas, has recently been signed. We hope to conclude more such agreements in the near future.
As regards the final part of the question, we need to convince other countries that -- whatever passports they hold -- Hong Kong residents are readily returnable to Hong Kong and will not be a significant source of illegal immigration. However, some countries require all visitors to have visas no matter where they come from. There is no realistic prospect of persuading them to make an exception for Hong Kong.
Countries/territories which allow visa free entry
to HKBDTC/BN(O) passport holders
1. Anguilla 2. Antigua & Barbuda
3. Austria (see Note 1) 4. Bahamas
5. Barbados 6. Belgium
7. Belize 8. Bermuda
9. Bolivia 10. Botswana
11. Brazil 12. Br. Virgin Islands
13. Canada 14. Cayman Islands
15. Chile 16. Colombia
17. Cook Islands 18. Cyprus
19. Dominica 20. El Salvador
21. Falkland Islands 22. Fiji
23. Gambia 24. Gibraltar
25. Greece 26. Grenada
27. Iceland 28. Indonesia
29. Ireland 30. Israel
31. Italy 32. Jamaica
33. Kenya 34. Kiribati
35. South Korea 36. Lesotho
37. Liechtenstein 38. Luxembourg
39. Malawi 40. Malaysia
41. Maldives 42. Malta
43. Mauritius (see Note 1) 44. Montserrat 45. Morocco 46. Netherlands
47. New Caledonia 48. Pakistan
49. Philippines 50. Poland (see Note 2)
51. San Marino 52. St. Helena
53. St. Kitts-Nevis 54. St. Lucia
55. St. Vincent and the Grenadines 56. Singapore 57. Solomon Islands 58. South Africa (see Note 2) 59. Spain 60. Sri Lanka
61. Swaziland 62. Sweden
63. Switzerland 64. Thailand (see Note 2) 65. Togo 66. Tonga
67. Trinidad & Tobago 68. Turks & Caicos Islands 69. Tuvalu 70. Vanuatu
71. West Samoa 72. Yugoslavia
73. Zambia 74. Zambabwe
Note 1: Austria and Mauritius require visas for BN(O) passport holders.
Note 2: Exchange of notes with Thailand (1975), South Africa (1990), and Poland (1991).
British nationality selection scheme
6. MISS EMILY LAU asked: Will the Government inform this Council of the progress of the first phase of the British Nationality Selection Scheme, including:
(a) the number of certificates of registration that have been issued, with a breakdown showing the number in various occupational groups prescribed by the Scheme;
(b) the number of passports actually issued;
(c) the number of applications that have been rejected and the reasons why; and
(d) the number of outstanding applications and the time required for all of them to be processed?
SECRETARY FOR SECURITY: Mr Deputy President, as at 16 November 1991, 3 606 persons have been issued with certificates of registration under the British Nationality Scheme. This includes 1 251 applicants and their 2 355 dependants.
A breakdown by class and by occupational group is as follows: General Occupational Class 204 (391)
Managers & administrators 38 (83)
News editors & journalists 26 (35)
Medical doctors 55 (126)
Legal professionals 51 (82)
Statistical assistants 34 (65)
Disciplined Services Class 83 (199)
Customs & Excise 35 (90)
Operations Department, ICAC 45 (102)
Royal Hong Kong Auxiliary Force 3 (7)
Entrepreneurs Class 31 (24)
Sensitive Service Class 933 (1741)
Note: Figures in brackets denote number of dependants.
Up to 16 November this year, 758 passports have been issued. A further 435 applications for passport are being processed.
So far, no applications have been rejected. We shall probably start to issue letters of rejection next month.
The number of outstanding applications is 37 761. The time required to process all these cases is about two years. We shall, however, try to give applicants an early indication of their chance of success. The Immigration Department will start later this month to notify all outstanding applicants of the position of their
applications.
Water control zones
7. MR GILBERT LEUNG asked: In pursuance of the enactment of the Water Pollution Control (Amendment) Ordinance 1990, will the Government inform this Council:
(a) how many applications for exemption licences have been received by the Administration in respect of the six water control zones throughout the territory; how many of them have already been approved; what are the estimated number of applications and the number of licences to be granted in the original projection; and
(b) how would the Government assess the extent to which the licensing system has been accepted by those affected; is the Administration satisfied with the
implementation of the licensing system as a whole; whether the objective of improving the quality of water in these water control zones can be achieved; whether there are any contingent measures to improve the situation if the need arises?
SECRETARY FOR PLANNING, ENVIRONMENT AND LANDS: Mr Deputy President, in answering this question I will distinguish between those Water Control Zones (WCZs) which were declared before the Water Pollution Control (Amendment) Ordinance 1990 came into effect on 1 December 1990, and those declared since that date. The reason for this is that while the Amendment Bill repealed the "exemption arrangements" which previously existed under the Water Pollution Control Ordinance, the Amendment Ordinance also provided that discharges or deposits which were previously exempt would be "deemed" to be licensed for a further two years or until a new licence was granted. No physical application for a licence by deemed licensees was therefore necessary in most cases. The four WCZs declared before 1 December 1990 were Tolo Harbour and Channel, Southern, Junk Bay and Port Shelter WCZs. In these zones the Environmental Protection Department (EPD) received 15 800 notices (or applications) of exemption, some 8 000 exemptions have been approved, 1 900 rejected and the remainder are being processed. On new discharges, that is, those discharges or deposits which came into existence after the zones were declared and which must therefore be the subject of a licence application, 922 applications have been received, 558 granted, and the rest are being processed.
As for our projections on the number of licensees in the four WCZs declared before the Amendment Ordinance came into effect EPD expected 19 000 applications for "exemptions" and received 15 800. (The remaining 3 200 discharges will be required to apply for a licence.) For the two WCZs declared since the Amendment Ordinance came into effect -- that is Deep Bay and Mirs Bay -- it is estimated that some 45 000 discharges, including industrial, commercial and domestic discharges, will need to apply for a licence. About 3 000 applications have been received so far and are being processed by EPD.
In assessing the extent to which the licensing system has been accepted I will, once again, look at the situation "before and after" the Water Pollution Control (Amendment) Ordinance 1990. In the first four WCZs that is Tolo Harbour and Channel, Southern, Port Shelter and Junk Bay, the statistics for applications for exemption are:
No. of
applications
Estimated No. for exemption
WCZ of discharges for a licence
Tolo 7,000 5,169 (73.8%)
Southern 7,200 6,496 (90.2%)
Junk Bay 1,855 1,855 (100%)
Port Shelter 3,170 3,076 (97%)
I would conclude from these figures that the licensing arrangements which existed when these four zones were declared were well accepted by those affected by the zones. In Deep Bay and Mirs Bay WCZ however -- the two zones declared since the Amendment Ordinance came into effect -- the exemption arrangements no longer apply and all discharges and deposits, except a discharge of domestic sewage into a communal sewer or unpolluted water into a public drain, must be the subject of a licence application. However, as indicated above few of the large number of domestic discharges in these two zones have been the subject of a licence application; applications received
against the estimated number of discharges in the two WCZs are 5.5% (Deep Bay) and 6.7% (Mirs Bay). The reason for this low level of application seems to be because New Territories village householders do not presently accept the need for the licensing of their domestic discharges under the WPCO. Discussions are now being held with the Heung Yee Kuk to find a way forward on this issue.
Despite this particular difficulty associated with licensing the large number of domestic discharges in the New Territories, the Administration is generally satisfied with the implementation of the licensing system. This is illustrated by the figures I have already mentioned for the first four WCZ that were declared before 1 December 1990. Moreover, the Administration feels that the licensing system has contributed to the improvement of water quality in these zones, particularly where beach water quality is concerned, for example, at Repulse Bay, Middle Bay, South Bay, Silvermine Bay and Tung Wan (Cheung Chau) beaches. However, it would not be fair to say that the licensing system has achieved these improvements on its own; in most cases short-term improvements have also been achieved mainly by diverting dry weather flows away from beaches. In some areas improvements to water quality have been achieved by controls via the Livestock Waste Control Scheme under the Waste Disposal Ordinance. Apart from these measures, there are no contingent measures to improve the situation; long-term benefits will not be realized until the full benefits of the Sewage Strategy come into effect. The full degree of benefit, and the overall
aim of achieving water quality objectives, will only be achieved through implementation of all the measures in the Sewage Strategy. These measures are:
(i) legislation to control the quality of industrial wastes and connect all sewage to the proper collection system;
(ii) enforcement of controls over what enters the environment, particularly from industry, restaurants, landfill sites and livestock farms;
(iii) an increase in public awareness of ways to reduce pollution;
(iv) construction of more sewers to collect the sewage, followed by full connection of sewage discharges to them;
(v) construction of new deep tunnels to transfer sewage across the city;
(vi) construction of more sewage treatment works to remove undesirable material before discharge to the sea; and disposal of this material safely;
(vii) construction of some very long sea outfalls to dispose of the treated water;
(viii) training of more personnel in operation and maintenance of sewage facilities;
(ix) planning for the future so that industrial and residential areas are separated. New development proposals, particularly land reclamations which affect the natural treatment capacity of the sea, will have to take proper account of environmental needs.
Tourism industry representative on the airport consultative committee
8. MR MARTIN BARROW asked: Having regard to the importance of the tourism industry to Hong Kong, will the government advise this Council as to why no representative of the travel, tourism, or hotel industries has been included in the Consultative Committee on the New Airport and Related Projects and can steps be taken to add a representative forthwith?
SECRETARY FOR WORKS: Mr Deputy President, the purpose of setting up the Consultative Committee on the New Airport and Related Projects is to provide a forum for collecting public views on the new airport projects and for the Government to explain the projects to members of the public. With this objective in mind, the Government has appointed people from a wide cross-section of the community to serve on the Committee.
Whilst members are not appointed on the basis of specific representation of any particular trade or organization, there is already a fair number of members associated directly or indirectly with the travel, tourism or hotel industries serving on the Committee. As the Consultative Committee was only set up very recently and it had just had its first meeting two days ago, consideration of changing its membership appears premature at this stage.
First Reading of Bills
PNEUMOCONIOSIS (COMPENSATION) (AMENDMENT) (NO. 2) BILL 1991
DENTISTS REGISTRATION (AMENDMENT) (NO. 2) BILL 1991
CONSUMER COUNCIL (AMENDMENT) BILL 1991
Bills read the First time and ordered to be set down for Second Reading pursuant to Standing Order 41(3).
Second Reading of Bills
PNEUMOCONIOSIS (COMPENSATION) (AMENDMENT) (NO. 2) BILL 1991
THE SECRETARY FOR EDUCATION AND MANPOWER moved the Second Reading of: "A Bill to amend the Pneumoconiosis (Compensation) Ordinance."
He said: Mr Deputy President, I move that the Pneumoconiosis (Compensation) (Amendment) (No. 2) Bill 1991 be read a Second time.
The purpose of this Bill is to raise the ceiling for advance payment of compensation by the Pneumoconiosis Compensation Fund Board to victims of pneumoconiosis or their dependants. The existing ceiling of $20,000 has been in force since mid-1988. It should be adjusted for inflation and be revised to $28,000 with effect from 1 January 1992.
The Bill has the support of the Labour Advisory Board.
Mr Deputy President, I move that the debate on this motion be now adjourned. Question on the adjournment proposed, put and agreed to.
DENTISTS REGISTRATION (AMENDMENT) (NO. 2) BILL 1991
THE SECRETARY FOR HEALTH AND WELFARE moved the Second Reading of: "A Bill to amend the Dentists Registration Ordinance."
She said: Mr Deputy President, I move that the Dentists Registration (Amendment) (No. 2) Bill 1991 be read the Second time.
The Bill seeks to expand the range of disciplinary orders available to the Dental Council of Hong Kong in the event of a finding against a registered dentist.
At present, under section 18(1) of the Dentists Registration Ordinance, there are four disciplinary orders available to the Dental Council. These include removing a dentist's name from the register permanently or temporarily, reprimanding the dentist or postponing judgment on the case for two years. It is also stipulated in the Ordinance that all orders made have to be published in the Government Gazette. However, in the case of minor offences, such as traffic offences, which bear no relevance to the practice of dentistry, the present disciplinary measures may not be appropriate. The Bill therefore proposes that the range of disciplinary orders be expanded such that the Dental Council may also consider:
(a) making no order at all; or
(b) reprimanding the dentist but not publishing the reprimand in the Gazette; or
(c) suspending the application of any order made.
In the light of the proposed power to suspend the application of any order made, the original power to postpone judgment for two years would be deleted. These amendments will provide the Dental Council with more flexibility in handling disciplinary cases in future.
Mr Deputy President, I move that the debate on this motion be now adjourned. Question on the adjournment proposed, put and agreed to.
CONSUMER COUNCIL (AMENDMENT) BILL 1991
THE SECRETARY FOR TRADE AND INDUSTRY moved the Second Reading of: "A Bill to amend the Consumer Council Ordinance."
He said: Mr Deputy President, I move that the Consumer Council (Amendment) Bill 1991 be read the Second time.
Following a review of its functions, the Consumer Council has made a number of recommendations. Legislative amendments are required in order to implement some of these recommendations. These amendments are set out in the Bill before Members.
The Bill seeks to clarify that immovable properties are within the Consumer Council's purview. This will remove any uncertainty in respect of the Council's ability to assist and advise consumers regarding property transactions and tenancy matters.
The Bill proposes to reduce the quorum requirement for Consumer Council meetings from a majority of the members, which means at least 12, to 11 members so as to give the Consumer Council some flexibility in the conduct of its business.
The Bill strengthens section 20 of the Ordinance which prohibits the exploitation of the Council's name and research findings for advertising purposes, by tightening the legal language and increasing the level of fines, from the present maximum of $5,000 to the proposed $100,000.
We are also taking this opportunity to update the Schedule to the Ordinance, which
contains a list of bodies outside the Consumer Council's purview. We propose to remove from the Schedule companies which are not subject to any special form of Government control or public monitoring, such as the Peak Tramways Company Limited and the Hong Kong and China Gas Company Limited, so that they will be brought within
the Council's purview. Several bodies which meet the criteria for exemption from the Council's purview, such as the Hospital Authority, are being added to the Schedule. Other amendments involve the removal of defunct companies and changes where companies have adopted new names.
Mr Deputy President, I move that the debate on this motion be now adjourned. Question on the adjournment proposed, put and agreed to.
Members' motion
CARE FOR THE ELDERLY
DR LEONG CHE-HUNG moved the following motion:
"In the light of the rapid expansion of our aging population, this Council urges Government to give immediate consideration to the formulation of an overall and comprehensive policy on the care of the elderly having special regard to their health and social needs."
DR LEONG CHE-HUNG: Mr Deputy President, I rise to move the motion standing in my name as stated in the Order Paper.
Mr Deputy President, senior citizens of today were the pillars of Hong Kong of yesteryear. We owe them our respect, if not our gratitude to their commitment in the past. They need to be taken good care of. Furthermore, lack of care for them will bring the current society huge economical and social problems.
Statistics have shown that there are about three quarters of a million people (or 13% of our population) that are now over 60 years of age and the number will rise to some one million by the end of this decade. A rough estimate based on census population indicated that the increase of elderlies aged over 65 in the next 10 years will be 58% whilst those aged over 75 will be 93%. With no proper care, they represent
a time bomb ready to blow up with no preset warning.
The problem is increasingly alarming in the face of family disintegration, a lot resulting from brain drain. The outcome is: more and more elderly people ended up living in solitude in aged homes, hospitals, private and public housing apartments.
They are a habitat of sorrow and grief. There is a ubiquitous fear among them that they are being deserted or forgotten by society, a phenomenon that is a disgrace to a society like ours which has made such tremendous economic success.
Mr Deputy President, our senior citizens are living in doldrums and left high and dry. Neither would they vociferously complain nor engage in red-hot fight for their interest and state their case. Their suffering must be arrested.
Mr Deputy President, it is all too easy for Government to make use of glossy deceit of high-toned policy objectives and couch lies under loads of financial figures to justify its "sincerity" in the provision of elderly service.
But these are no bullet-proof vests. There is much catching up to do. We cannot turn a blind eye or afford to avert our eyes from the fragmented and piecemeal services that Government is providing. The elderly people are starved of adequate and decent care. The adverse effect may be imponderable.
There is, Mr Deputy President, a dire need for the formulation of an overall and comprehensive policy on the care of the elderly having special regard to their health and social needs.
Mr Deputy President, Government emphasizes in the White Paper: Social Welfare into the 1990s and Beyond that the spirit of elderly care is to keep them actively involved in the community, and I repeat, to keep them actively involved in the community. But how can we keep them active in the community unless we keep them healthy? More importantly is what proper directions are available when eventuality falls on them that they become ill?
Mr Deputy President, let me now turn to elaborate a number of services (or, should I say, disservices) that Government is providing for the elderly at this point in time:
(I) There is virtually no preventive care
If our intention is to keep elderlies active in the community, ways and means must be established to keep them healthy as long as possible.
Statistics have shown that the commonest morbidity in the old people are hypertension, heart and blood vessel diseases.
Is there any programme or advice the elderly can be aware of the surfacing of these problems? Are there enough screening facilities to have these detected so that early treatment can be instilled? More importantly, are there any education programmes for young people to assist them in the prevention of the development of these pathologies when they grow old?
(II) Fragmentation in service and a lack of co-ordination in service provision
Whilst the machinery for the provision of care for our citizens of sunset years is available, there is a blatant disruption in co-ordination.
Let me spend some time to cite two examples for exemplification:
Mr CHAN of over 65 was taken ill. He visited a nearby government clinic and, after the usual queuing-up and waiting, was seen by a doctor who gave him a routine treatment without special consideration of his geriatric status. He did not improve and was subsequently admitted into an acute hospital.
Condition improved but on discharge he was not given the proper co-ordinated aftercare so very needed by this age group. It was not surprising, therefore that Mr CHAN fell sick again, requiring again readmission.
After a few similar exercises, the idea of a day care centre dawns over Mr CHAN's son. The junior Mr CHAN was dismayed, however, by the uncivilized opening hours of 8 am to 6 pm of this centre. How can he and his wife fit in their working time of nine to five to bring the senior Mr CHAN to the centre which opens only from 8 am to 6 pm. Facing a situation of despair, the junior Mr CHAN applied for a place in a care and attention home knowing very well that he might have to wait some three to four years to get a place. In the ensuing period, the older Mr CHAN required repeated hospital readmission. His condition deteriorated, he became disabled and
was finally forced to find a place in a private old age home.
Let us now look at another scenario. Old Mr WONG has no family support and was advised by a social worker to seek assistance from the Social Welfare Department. But because of the presence of some old age chronic illness, he was advised after assessment by the Social Welfare Department that it would be more suitable for him to find a place in an infirmary under the Hospital Services Department. After
consideration, the Hospital Services Department however felt that he is more suitable for care and attention homes under the Social Welfare Department.
Old Mr WONG thus faces the common phenomenon of tossing between two seemingly unco-ordinated departments and ultimately ended up in a government-sponsored place of a private old age home.
The likes and plights of Mr CHAN and Mr WONG are all too so many. They highlighted many ironies and discrepancies that are overtly daunting in front of us and I could mention a few:
(1) The lack of proper co-ordination of the different machinery set to assist the senior members is the cause of repeated hospital admissions and readmissions and must be partly responsible for overcrowding of acute or chronic hospital beds.
(2) It is difficult to apprehend the barrier and separation between care and attention homes and infirmaries, let alone they are each under the control of different departments. The care of the sick aged is a spectrum that spans from acute care through care and attention homes and infirmaries. This can best be done if these are managed under one roof.
(3) The unco-ordinating state has led to an ever-enlarging waiting list both at the care and attention homes and the infirmaries. The current waiting list of care and attention homes stands around 8 000 and infirmaries at 3 000. But how many actually get admitted in the course of time? An initial finding of a research group on residential care of the elderlies shows that out of 100 people aged between 75 to 80 who have applied for a place in an infirmary, only around two dozen were still alive when a place was finally available for them.
(III) Inadequate geriatric teams and ineffective utilization of the existing facilities
A total of seven geriatric units are now available in Hong Kong. Geriatric units are responsible for acute care and rehabilitative care of the elderly. Whilst it may not be advisable to have more geriatric units, there is a need for more geriatric medical teams to cater for the needs of all acute hospitals in Hong Kong as all of them would have a fairly high proportion of patient population over 65 years old. Only two geriatric consultants are currently available in the current government hospital services. A recent survey study in Hong Kong has shown that some 41% of medical admissions are of the age of 65 and 21% are of the age of over 75. This highlighted the need for more geriatric teams.
Furthermore, the expertise of these specialists is not being properly utilized to cater for our elderly populace. Effectively, they should serve and co-ordinate all the available old age care machinery and not limited to their own hospitals and units.
The end result is that they only function to treat the acutely sick. To quote from one of my colleagues in the geriatric field: "The medical services are chasing after complications rather than early intervention". Mr Deputy President, how depressing!
What then are the possible solutions?
I would like to venture some suggestions basing on the afore-mentioned problems and to have a sensitive discussion with the different geriatric groups and bodies:
(1) There should be a territory-wide public health campaign to promote education for early detection of common old age diseases.
(2) There should be a territory-wide public health campaign to educate the public on prevention of common old age diseases.
Many common old age diseases are preventable if precautionary measures are taken at a young age. Hypertension for example, Mr Deputy President, can be prevented to a certain extent by cutting down salt in the diet. Cardiovascular diseases likewise can be minimized by taking a low fat, low cholesterol diet. The social sentiment must be aroused with people at large ready to accept such campaigns. Government has made good timing for launching AIDS and anti-smoking campaigns.
Similar vigor and determination ought to be done for preventing common old age diseases.
(3) There should be the establishment of a co-ordinated body for the care of the elderly.
Not only is it vital for Government to revitalize a central committee on service for the elderly, but this body should also be given wider representation and professional input. It must be given the proper recognition and power to advise on the total overall policy over elderly services. In this aspect, Mr Deputy President, I call for the setting up of a Council for the Aged on the same line as those established in Singapore. Ironically, Singapore who started some six years after Hong Kong to provide service for the aged is now far ahead of us.
(4) There should be the development of a proper district-based network for the care of the elderly. This should be in the form of a multi-disciplinary care committee comprising health visitors, physiotherapists, occupational therapists, medical social workers and primary health care doctors with a Geriatrician as the head of the team.
(5) There should be the development of a proper networking of geriatric teams in the existing acute hospitals. To this end, Mr Deputy President, more geriatric consultants must be established.
(6) There should be an urgent need for increase in residential care places.
The sorrowful state of waiting lists for care and attention homes and infirmaries calls for not only a rapid increase in these places but also a breaking down of the barriers between these two types of residential care centres. Whilst there has been a continuous call to build these centres, it should be noted that such should only be a long-term measure and they are costly. As an immediate short-term improvement, Government could look at the increasing utilization of bought place in private old age homes with their standards being controlled by the forthcoming legislation.
Other areas Mr Deputy President, of course, should also be looked at and be taken into serious consideration. These include the subvention of a full range of hospital care and the considerations of providing comprehensive dental care for senior citizens.
Government will be cast in a very unfavourable light if the above-mentioned improvement package which is dear to the hearts of the people, and especially the elderly, is still put in mothball state.
Mr Deputy President, Members of this Council are very concerned with care of the aged as exemplified by the number of participants in this debate and also by the fact that an ad hoc group was formed to formulate the direction for this motion. Nobody, Mr Deputy President, also so far, I am glad, has suggested an amendment.
We realize that the scope of the care of the elderly is not exhaustive but has decided to concentrate only on the basic, that is, health and welfare, on which areas my colleagues in this Council will so address.
Mr Deputy President, many things in this world can wait, but the solution to formulate the care for our twilight citizens is an urgent matter. There is no procrastination and there should be no delay. For timing, Mr Deputy President, is never on their side!
Mr Deputy President, it would be doomsday for this bustling economic city if Hong Kong were to face the reality of the Chinese saying: " -- when everything is too late".
I do so move.
Question on the motion proposed.
MR HUI YIN-FAT (in Cantonese): Mr Deputy President, during the recent years, the Government has called upon all departments to reduce their expenditure for the reasons of combating inflation. In my opinion, as long as the qualities of social services provided to the public will not be affected, it will not be difficult to win the understanding and sympathy of the general public. However, the measures adopted by the Government should be appropriate and reasonable. As a matter of fact, the
reduction of expenditure should be viewed as a means to test the ability of government departments in enhancing the cost effectiveness of resources, it never implies to curtail arbitrarily on Government's commitments to social services. Nevertheless, as far as the present services and welfare provided to the elderly are concerned, the attitude of the authority concerned inevitably makes us feel dismay. The main
reason being the resources provided by the Government are far from being adequate, and reductions are not done in right ways. There are plenty of specific examples, and I can easily cite three of them.
(1) The care and attention homes for the elderly run by the voluntary agencies are intended to provide institutional health care services for those elderlies who suffer from poor health and senility. However, due to the lack of resources, the total number of persons registered on the central waiting list for infirmaries has now increased to over 9 000. On the other hand, those weak and feeble elderly people who ought to receive proper care in the infirmaries are bound to be stranded in the care and attention homes as "convalescent cases" due to the shortage of bed places in the infirmaries. Although the Social Welfare Department has set up a convalescent unit for every 20 convalescent cases in care and attention homes, the facilities and quality of service can never be comparable to the infirmaries provided by Hospital Authority. Making such elderlies receive a second-class care would certainly be impossible to improve their health condition, let alone relieve the pressure on the service, and in view that convalescent unit has to be set up in care and attention homes, the demand on such bed places would be strained further.
Speaking from the view of the effectiveness of resources, only through improving the health condition of the elderly could we reduce the pressure of inadequate manpower and bed places in care and attention homes. However, the Government has been turning a blind eye to this situation and allowing the transfer of the shortfall of the medical fund to the already insufficient social welfare services. I hope that the Central Co-ordinating Committee on Services for the Elderly which would be re-convened shortly would address this problem and map out a comprehensive programme to solve the ever deteriorating problem of institutional care for the elderly.
(2) To develop a social atmosphere of respecting and caring for the elderly through community education will help to reduce the dependence of the elderly upon the Government. One feasible way being the designation of a Senior Citizen Day, so that during a certain period of the year the people of Hong Kong will focus all their attention onto the old people. As time goes by, an atmosphere of respecting the elderly may take place in our society, however, even though the voluntary agencies had been making this plea throughout the past 13 years, and even the Ad Hoc Committee on Community Health on Ageing under the Social Welfare Department has agreed to designate the third Sunday of every November (the day when the Hong Kong Council of
Social Service designates as the Day for the Elderly each year) as the Senior Citizen Day, the Government did not give any consideration to this suggestion. How can the authority claim to be respecting the elderly? How can we enhance the care for the elderly through community care and neighbourliness?
(3) As more expenditures have to be met by those persons aged 65 and above, the Administration provides them with a monthly Old Age Allowance of $373 and Higher Old Age Allowance of $425. Though being an insubstantial amount, the Government imposes many restrictions on the recipients and a lot of human resources are deployed to scrutinize such allowance. One of the unreasonable restrictions being the
allowances would be frozen should the recipients be away from Hong Kong for more than three months. This will only cause more inconvenience to those elderlies with special needs, but never would it reduce the government expenditure in this respect. Instead, it would only waste the human resources and administrative expenditure.
This policy is in fact unrealistic in the sense that it does not cater for actual needs. In face of gradual disintegration of family support in providing care for the elderly, coupled with the emigration of young family members, a large number of old and infirm elderlies who need special care have to stay in Hong Kong, inducing a very heavy burden to the medical, housing and welfare services of the Government. To fully utilize the effectiveness of such allowances, and to reduce the pressure to the above three aspects, may I urge the Administration to consider removing such condition so that the recipients of Old Age Allowance need not subject to a specified residing period in Hong Kong. They may choose to live in the Mainland at their own free will and to meet their own needs, so as to be taken care of by their children or relatives in the Mainland. I believe that with the $300 or so they receive in Hong Kong they may enjoy a better living in the Mainland than in Hong Kong. This has been proven effective in countries such as Japan where the cost of living is high. I believe that this flexible approach will surely benefit Hong Kong.
On the other hand, Mr Deputy President, provision of primary health care is the first step to prevent illness, as far as the old people are concerned, certainly the earlier their invulnerability against illness is enhanced, the better. However, I am concerned that under the existing system, old people between 60 and 64 years old are not entitled to Old Age Allowance, consequently they are also not entitled to Old Age Supplement under the Public Assistance Scheme. As far as the principle for granting the above allowances is concerned, old people in such age group is the
forgotten people who live only on the limited savings. I therefore suggest that the
Government consider adopting a more generous approach in the means test thereby making available a higher special aid to such group of elderly so as to meet their ever increasing needs in various aspects. In the long run, with the improvement of primary care to the elderly, it will alleviate the pressure on the Government in the provision of medical and health care services.
Mr Deputy President, all in all we have been adopting a short-sighted approach of "curing the symptoms but not the disease" in addressing these problems, resulting in a shortage of resources, a waste of resources or failure to achieve its effectiveness. The Government should in fact try its utmost to reverse this adversity. In the light of this principle, I oppose to any measure of restricting the improvement of health services for the elderly. In my opinion, the Central Co-ordinating Committee on Services for the Elderly which will be re-convened may provide the right directions of co-ordinating all elderly services and enhance the cost effectiveness of resources. But it is most important for the Government to eradicate its long-standing negative and prevaricating attitudes towards this matter. It is a hard fact of life that Hong Kong is having an ageing population, only through the positive response of the Government and its willingness to make long-term commitments that our elderly may lead an easy life in their twilight years.
Mr Deputy President, with these remarks, I support the motion.
MR MARTIN LEE (in Cantonese): Mr Deputy President, China has long been known as a "country of propriety and justice", and respect for the aged is one of the most important elements of Chinese civilization. Just as what Mencius has taught us "Care for my own aged parents and extend the same care to the aged parents of others; love my own young children and extend the same love to the children of others.", we can basically practise the second part of the saying. Which parent does not love his/her own children? Sometimes excessive love will spoil them. In our community, many
kind-hearted people adopt orphans, and they even intentionally adopt physically handicapped orphans. However who is prepared to adopt an aged person who is not cared for by any one? Some people are not even prepared to take care of the aged ones in their own homes, or just leave them behind in hospitals after they have recovered from an illness, without thinking of taking them home.
Measures by the Hong Kong Government to take care of children, when compared with care measures for the elderly, are obviously much better. This gives one a feeling
of "taking care of the young but not the old". Both in education and in social recreation, the Government takes good care of the needs of our next generation. However when it comes to the elderly, the situation is completely different. The Government has indeed done too little in the provision of services for the elderly.
Improvement of services for the elderly can hardly be achieved by means of one or two short-sighted measures. Unless the Government has a set of longer-term policies of social welfare and care for the elderly, the problem of the elderly will continue to deteriorate with the increase of the elderly population and the inadequacy of social support service. In fact the crux of the matter lies in the shortage of resources for social welfare and care for the elderly and also in the long neglect of the problem by the Government. In terms of economic achievements, Hong Kong can, with pride, compare with any other place in the world, and the Hong Kong Government has always emphasized the dynamism and adaptability of the Hong Kong economy. But behind the prosperity of our society, there are always a large number of neglected old people.
The old people being neglected now had been young before. In their younger days, they had struggled hard to make a living.
The extent and nature of one's contribution to society vary from person to person. Everyone works and struggles for a living, and holds steadfastly to his/her station in life. The economic miracle of Hong Kong is backed by countless quiet contribution of this nature.
The younger generation of Hong Kong is a more fortunate generation. They have not experienced the harrowing and turbulent days of war, nor have they endured the hardships during reconstruction of Hong Kong in the early part of the post-war period. On the contrary, after they were born, the young generation today could enjoy at once the fruits of Hong Kong's economic prosperity. However, without the trees planted by the previous generation, how can those who come along later cool themselves under the shade? Many elderly people, either due to the pressure of work in making a living when they were young or a lack of knowledge, failed to make arrangements to adequately provide for their living after retirement, and therefore they have to suffer the penalty of having no support in their old age. Is this fair to them? Are we going to insist on not setting up retirement protection schemes for workers and let these tragedies repeat themselves?
Some among the elderly may be more fortunate in having large numbers of children and grandchildren and well taken care of by their families; but there are others who are not so fortunate and who have no children, and after working hard during their active working life they finally have to sleep in the streets.
Even for those elderly people who have children, they may be abandoned in Hong Kong as their children emigrate abroad as 1997 draws close. Among the 60 000 emigrants each year, how many old parents or dependants have they left behind in Hong Kong without any support?
For a long time, the Government appeared to take it that the elderly are the best behaved, and quietest. Consequently there has been the least response to the demands for social security and social support services. The Government may, according to its own standard, fix the Old Age Allowance at some $300 per month, and think that it should be enough. However in the eyes of many elderly people, this is but a kind of charity. Hence many of the elderly people are unwilling to receive this charity thrown at them even though they may have the need. Indeed, this impinges on the dignity of the elderly people.
Having laboured all their life, the elderly people no longer have the ability to work. They may also have lost their spouse or friends of many years, and they seem to have lost all. What little is left with them which they still possess is probably their personal dignity. Furthermore this dignity can only become stronger and stronger after the test of decades of hard living. This dignity will all the more be treasured by the old people, because it is all that is left to them in their old age.
The elderly people expect to be respected by others, and they want others to treat them as part of society, and not persons in the periphery of society who live a parasitic life on charity.
The present social security benefits cannot provide adequate financial protection to the elderly; at the same time, when the elderly population keeps growing and the traditional family ideals are dissipating, this problem will become even more serious.
As to respect for the aged, I believe no other civilization in the world places as much emphasis on it as the Chinese civilization does. Yet when many developed
countries have established the so-called "senior citizen" system and provide preferential treatment to them in their various daily activities (such as transport allowance), what has this international city of ours, which claims to be one of the areas with the fastest economic development, done for them?
As a matter of fact, there is much the Government can do. Apart from allocating more resources to provide more services of social support and care for the elderly, the Government may also, through the improvement of manpower and resources management, provide more needed services to take care of the elderly. For instance, the youth centres in many districts are now left empty in the mornings. The Government may arrange to open these youth centres during such hours for use by the elderly. What the elderly need is not large-scale functions or activities; what they need may be just some social get-together. If we can arrange for the old people to gather
together frequently, this will give them more and fuller spiritual support, and moreover such arrangements are easy to make.
Members of this Council who are from the United Democrats of Hong Kong will give views in the present debate on matters relating to the elderly, such as transport allowance, community services, community care, medical care, cultural and recreational activities, caged apartments, hospice and elderly people problems in the new towns.
Finally, to match the subject of this debate, and to set a practical example of "respecting the aged", I hope Members of this Council henceforth will allow those advanced in years to speak first, so that they can go home earlier to take a rest. However I have to declare my interest here: if in the 1995 elections to the Legislative Council I get re-elected and climb on the "through-train", then by mid-1998 I shall be joining the ranks of elderly Members. I hope by that time I shall enjoy the most preferential treatment and go home to take a rest immediately after my speech.
Mr Deputy President, with these remarks, I support the motion.
MR DAVID LI: Mr Deputy President, at the outset, I must declare my interest as Chairman of both the St. James Settlement Executive Committee and the Salvation Army Advisory Board. I therefore bring to this debate both knowledge of, and concern for, the issues we are discussing today.
The concept of the "Family" -- tightly-knit and self-sufficient from grandchildren to grandparents -- is a fundamental and revered element of Chinese culture.
Parents support and nurture their children through their youth and into maturity. Then, as their children start their own families, the parents are often there to look after the grandchildren. The children, in turn, later provide for and support their parents in their old age.
In Hong Kong, we want to take care of our own.
But what happens when the children cannot provide for their parents -- not because they do not wish to, but because they simply do not have the time, the space at home or the financial means?
What happens when the parents become infirm and the children work 50 to 60 hours a week, live in flats of no more than 40 sq m in area, and are struggling just to support themselves and their own children?
Who takes care of Hong Kong's parents then?
To date, the Administration has relied on "community care" to provide for the elderly, on care in the community and on the Chinese tradition of "Family".
Children are subsidized for taking care of their parents. To encourage care "at home", children are given annual tax allowances and special treatment in obtaining public housing.
However, in today's modern, urban environment -- an environment of soaring medical costs, double-digit inflation and 40-square-metre flats -- this hands-off, ad hoc approach to care for the elderly is not enough.
Yes, money -- or the lack thereof -- is an issue. But it is equally important that we spend what money we have wisely. Here, the Administration's current piecemeal approach is an obstacle.
The Administration, in co-operation with this Council, must develop an overall and comprehensive policy for caring for the elderly. It must work to provide a
"safety net" for all our senior citizens -- and their families -- who fall through the cracks of the "community care" system.
Caring for the elderly involves many services, many disciplines and many professions. There are social workers, doctors, nurses and public housing officials -- all of whom are involved in programmes designed to assist our senior citizens.
These programmes are operated and supervised by many different government departments and voluntary agencies. Yet, at present, there is no fixed structure -- no set channel -- through which the activities of these departments and agencies are co-ordinated.
To promote greater inter-departmental co-ordination and co-operation, to improve the managerial and administrative framework of the Government's programmes for the elderly, and to enhance the relationship between the Administration and the voluntary agencies, I would urge the Administration to establish an overall co-ordinating
committee to oversee the planning and implementation of services for our senior citizens.
Such a body already exists for the care of Hong Kong's handicapped. The Rehabilitation Development Co-ordinating Committee has been an administrative "success story".
Why can we not repeat this successful formula in providing an appropriate managerial and administrative framework for caring for the elderly?
Better co-ordination among the various government departments and voluntary agencies which provide these services would enhance administrative efficiency and effectiveness. Ideas and experience could be shared, financial and human resources pooled, and priorities set.
Through an overall co-ordinating committee, the Government could better monitor public expenditure to achieve greater value for money.
Programme quality-control could be improved, and resources could be channelled more quickly and more efficiently to those services which are most needed -- and most effective.
At present, two areas which deserve greater government attention are medical and health screening and institutional care.
Medical and health screening is a vital component of "preventative medicine". By educating the elderly on the specific health risks they face and how they can be avoided, problems can be solved before they happen.
The Report of the Working Party on Primary Health Care, which was published in December of last year, recommended random out-patient screening for persons aged 60 and above.
However, if such "preventative" measures are to be truly effective, such screening should begin at an earlier age and must be conducted on a more regular basis.
For those persons who are beyond the reach of preventative medicine, those persons who are either too ill or lack the physical, mental or financial ability to take care of themselves, we must provide suitable facilities to ensure that they receive the care and attention they need.
At present, institutional care is provided by two very different types of facility: "Care and Attention Homes for the Elderly" and infirmaries for the elderly. The former offer basic residential services, while the latter provide intensive medical care.
There are long waiting lists for both types of facility. But beyond the "numbers" problem, there is again the problem of co-ordination.
These facilities are administered by different government departments, and it is often difficult to decide which facility is the most appropriate for an applicant. As a result, it is easy for people to fall through the cracks.
Hong Kong needs to co-ordinate its programmes of institutional care for the elderly. It may be prudent to establish a new type of facility which would offer a broader range of medical, residential and social services.
The "Nursing Home" has proved a most successful concept in many other places throughout the world. Why can we not follow this successful formula in providing suitable institutional care for our senior citizens?
Hong Kong's elderly are not asking for charity. They only ask for the dignity that is their right. For all they have done for Hong Kong -- for us -- we owe them much.
In Hong Kong, we want to take care of our own. Let us not fail in our individual and collective efforts to fulfil this tradition.
With these remarks, Mr Deputy President, I support the motion.
MR TAM YIU-CHUNG (in Cantonese): Mr Deputy President, according to the latest Census statistics, there are over 700 000 people in Hong Kong aged 65 or above. What is the living conditions of these 700 000 people? We can try to get a full picture by looking at their different aspects of life.
If you have been to the government out-patient clinics, you will find that most of the people queuing up outside the clinics are the elderly. In order to save several tens of dollars, they have to queue up for several hours. In winter, they even have to bear the piercing cold winds. According to the information provided earlier this year by the Medical Insurance Study Group, more than one-third of the hospitalized patients are elderly people over 55, and more than 20% of them are people over 65. According to another survey on people seeking out-patient services, other than
infants under four, those in the age group of 65 or above account for the highest proportion of people seeking out-patient services, standing at 20% over a two-week period.
As regards housing, there are 5 650 caged bedspaces where the living conditions can be regarded as the most abominable. Most of these bedspaces are occupied by elderly people. Despite such an adverse living environment, cage lodgers and other aged tenants living in old buildings, regarded as city slums, have to worry all the time that their homes will be demolished for redevelopment. They may then be driven onto the street and become homeless. Recently, I found that several more old women have become street-sleepers in Sheung Wan where my office is situated. I believe they are formerly tenants of the old buildings in the vicinity and have become homeless after the demolition of their buildings. On the other hand, a large batch of old people, presently living in old housing estates to be redeveloped in the near future, will be forced to move, like human footballs, to other places due to the lack of
single-person and two-person housing units.
As a Legislative Councillor representing the labour sector, I naturally focus on the question of working conditions when considering the problem of the elderly. According to the information contained in the report of the Central Committee on Services for the Elderly published in September 1988, in 1986, 54% of the aged workers earned less than $2,000 a month, 65% of the elderly worked more than 45 hours a week, and over 20% of them worked as many as over 65 hours a week, that is, working 11 to 12 hours a day. Please take note that those having to work 11 to 12 hours a day are in their 60s and 70s. Such cases as reported to the trade union are indeed numerous. Notwithstanding the fact that old people have to work from eight in the morning to eight at night for a meagre $2,000 to $3,000 a month, they also have to worry about being displaced by overseas workers imported by the Government and their employers. This is the plight of the 140 000 elderly workers aged 60 or above. How can those elderly who can no longer work maintain a living? According to the Report of the Social Welfare Department 1988-89, elderly people accounts for 67.11% of all those applying for public assistance. This ratio is on the increase.
Although the above conditions do not apply to all 700 000-odd old people, we can still manage to get a clearer picture, that is, Hong Kong's elderly are facing great difficulties in terms of health, living and working conditions. Most of them are on the fringe of poverty, being the most neglected and the least able to help
themselves. How do these elderly people relate to the society of Hong Kong?
Those at the age of 60s or 70s now are strong young people of 20s or 30s when the economy of Hong Kong started to develop in the 1950s. During that period when our economy and wealth were built upon the supply of cheap labour, they formed an industrious labour force that promoted the economic take-off of Hong Kong. They have, through their work, devoted their blood, sweat as well as their youth to build up this modern and international city. However, what they have got in return for their lifelong hard work is a miserable plight in their twilight years. Is this their own tragedy or is it the shame of Hong Kong?
Being a very competitive commercial society, Hong Kong advocates the philosophy of the survival of the fittest and the elimination of the weak. However, with the development of our society and the increasing intervention of the Government in the economic and social spheres, should we not consider establishing another social
philosophy in treating the elderly -- the pioneers of our society? By adopting a
humanitarian spirit basing on mutual help and tolerance, we can help the weak by building up a fair and equal social system so that every member of society can share the fruits of economic success. We should be aware that in the world today, economic development is no longer the only yardstick for assessing whether a society is
advanced or not. Equality, justice and humanitarianism have become loftier goals to be pursued. Hong Kong should not go against this trend.
As regards the specific proposals of this motion, such as increasing the number of single-person and two-person housing units, providing transport subsidy to the elderly, enhancing the medical care for the elderly, building more hostels for the age, increasing old age allowance and setting up a Committee on the Elderly and so on, I believe my colleagues will elaborate on these matters. I do not intend to repeat.
However, I would like to raise one point. Many years ago, I put forth a proposal -- which the Honourable HUI Yin-fat also mentioned a few moments ago -- regarding the drawing of the old age allowance; but this proposal was not accepted by the Government. At present, elderly people will not be eligible for the allowance if they leave Hong Kong for more than 90 days a year. To those elderly who would like to move to China to spend their remaining years or to be united with their family members, this restriction is most unfair. Since they have toiled away the greater part of their lives for Hong Kong, we really should not hastily deprive them of the meagre monthly allowance of several hundred dollars given to them in appreciation of their contribution. Over the past few years, this restriction has deprived more and more elderly of their rights to claim old age allowance. The number of elderly affected increased from 3 710 in 1988-89 to 5 720 in 1990-91. In fact, many people return to China to escape the increasingly lonely and poor living conditions in Hong Kong. Since we cannot allow the elderly to pass their twilight years comfortably, we should not deprive them of their last right to seek for a better life. I thus again urge the Government to review the above policy and scrap such restriction.
Mr Deputy President, with these remarks, I support the motion.
MR ANDREW WONG (in Cantonese): Mr Deputy President, I support the motion moved by Dr the Honourable LEONG Che-hung.
I believe that the subject for our debate is most timely. In the past our social leaders have been more concerned about some highly sensitive political issues at the expense of many social problems which merit our attention. One can only take a
resigned attitude towards this situation. As regards today's debate, Mr Deputy President, I would like to make the following points:
(1) Increased welfare funding for the elderly
Many developed societies have to face the problem of an ageing population and Hong Kong is no exception. Results of our census show that 716 901 or roughly 13.7% of our population are above 60 years of age. If we make a projection according to this figure, over 15% of our population will be above 60 years of age by 1999. However, the yearly government funding on the care for the elderly has fallen far short of the growth of our aged population and the annual inflation rate.
It is the basic responsibility of the Government to provide necessary services, including Old Age Allowance, to the elderly who have considerable contribution to the society of Hong Kong. In setting the level of allowance for the elderly, the Government should make its decision on the principle of "not only letting the elderly get a living and but also live a good life". The allowances provided to the elderly at present are too meagre -- $373 for those aged between 65-70, $425 for those over 70 years old and possibly an additional amount of $1,600 as public assistance. For people without a job, these sums will be difficult for them to make both ends meet, let alone to live in comfort.
(2) Travel concessions for the elderly
With the increase in population, the people of Hong Kong do not concentrate on several densely populated urban districts like they did 10 or 20 years ago. They have to move gradually to new towns far away from urban areas. Travelling expense has become a necessary but also luxurious outlay for those old people who are already retired. For those living in Ma On Shan, a weekly visit to New Town Plaza should not be considered as a luxury; yet the travelling expenses incurred are quite
considerable for people with hardly any income. All along we do not have any travel concession scheme for the elderly. In view of our demographic movement, there is a need for the Government to consider introducing such a scheme.
(3) Compulsory retirement protection scheme
The Government has agreed in principle to introduce a compulsory retirement protection scheme which has marked a good beginning of a sound security and welfare
system. I would like to take this opportunity to urge the Government to introduce as soon as possible such a retirement protection scheme though the Government might abolish the Long Service Payment Scheme upon implementation of the former. For workers who are now in their middle age or near retirement, this scheme cannot meet their immediate needs. It is because even though the retirement protection scheme is to be implemented without delay, there are only a few years left for contributions to be made to the provident fund before the workers retire; hence the sum accumulated will be small. Also, by then they are no longer covered by the Long Service Payment Scheme. I therefore suggest that the existing legislation on long service payment be continued or at least, as an interim arrangement, the Long Service Payment Scheme be continued to apply for a considerable period of time after the introduction of the retirement protection scheme.
(4) To encourage the elderly to re-integrate into society
In working out the areas of service for the elderly, the Government has all along placed emphasis on care and attention and living and recreation only. For the elderly who are physically fit the Government did not encourage voluntary agencies to provide service for their re-integration into society. As a matter of fact this group of old people who are still active and energetic can form an additional force for the service of the elderly and the rest of the community. Although at the moment there are diversified training programmes provided by voluntary agencies such as training for voluntary services and health care, these programmes are still inadequate. The Government should give full support to the implementation and promotion of these programmes so that elderly persons can reintegrate into society and help each other in community services.
(5) Social ethos
It is regrettable that the Chinese tradition of respect for the elderly has gradually been forgotten. Cases are often found of abandoned old people sleeping in the street or committing suicide. It is most unfortunate that the elderly are ill-treated not only by young people but perhaps also by adults. Our education system has now moved towards catering for the social needs. The importance of moral education to society has been overlooked. Grammar, mathematics and science are considered more important subjects than moral education in our school curricula. Mr Deputy President, we may perhaps have entered an era of absurdity. The errosion of our moral obligation to the elderly may account for our neglect of the aged. We
however cannot afford to abandon them, otherwise we will be condemned as immorally irresponsible. As children and Members of this Council, are we convinced that moral obligation can be fulfilled by giving the elderly some money in the form of allowances? Or do we believe in the gross deception that money can buy us blissful moments so that we will be spared the self-condemnation by giving away such small sums of money? Why can't we follow the advice the Honourable Martin LEE gave a while ago and care for the elderly in as well as outside our family?
Mr Deputy President, during a tour to Beijing not long ago I saw a picture of a figure depicted in Chinese apophthegms, which is entitled "the anguish of the old". I have circulated copies of it to our honourable colleagues hoping we could all bear in mind the advice contained in it. We should not feel disgusted with the elderly because we will all get old. Not everyone can have a handsome pension for living a comfortable life after retirement. I hope the Government and Honourable Members in this Council can take this into consideration when formulating polices.
Mr Deputy President, with these remarks I support the motion.
MRS PEGGY LAM (in Cantonese): Incorrect name results in no justification. Mr Deputy President, there is a saying that "we must get the name correct before we can justify our arguments". Before I speak on today's motion, I would like to talk about the term "elderly".
We often use the term "elderly" and its synonym in the western world is "senior citizens". The word "senior" connotes rich experience, virtuousness and respectability. It reflects a society's respect for the aged citizens and even gratitude to them.
But the term "elderly", which is being used in Hong Kong, only refers to people of old age and is very different from the word "senior". I am not pedantic about the wording but the term "elderly" does give people an impression that the Government and our society always think lightly of the aged citizens and assume the airs of benefactors.
There are a number of ways to take care of the elderly, but I would like to concentrate on the following areas.
First, formulation of an overall and comprehensive policy to take care of the elderly
This can be said to be the blind spot of the Government's "policy towards the elderly". The White Paper on Social Welfare into the 1990s and Beyond published in March this year gives the impression of treating the services for the elderly as some sort of relief work. In fact, care for the elderly is a means to repay our senior citizens instead of a kind of relief and is a civil right rather than a social welfare to the elderly. For this debate, I will use the term "Care for the Elderly" throughout my speech.
A correct understanding is very important for the development of the "Care for the Elderly" because it will directly affect the direction and implementation of the policies, the attitude of the general public as well as the co-operation from the private corporations.
Therefore, I would like to take this opportunity to urge the Government to set up a co-ordinating body along the line of the Central Committee on Youth so as to give proper emphasis on the senior citizens and particular consideration to their rights, and thereby formulate an overall and comprehensive policy. In fact, the Government did have a "Central Co-ordinating Committee on Services for the Elderly" in 1981, but unfortunately it was disbanded in 1985.
Once a comprehensive policy towards the elderly has been set, the manpower and resources within the concerned government departments can be prioritized accurately.
One of the important functions of this inter-departmental central body should be to promote the respect for the elderly as an important part in civic education and family education. The Government must also set an example. In fact, the Government's existing policy in certain areas involves some discrimination against the senior citizens and has to be reviewed. For instance, the dependent parent allowance is on the low side and only one child can claim the allowance. This gives people a false impression that only one of the children must support their parents' living whereas the rest can shirk their responsibilities. Is it impossible to allow all children to share the responsibility to repay the parents? In fact, the allowance is not enough at all if the parents really depend on their children's support.
It is also important that such a central co-ordinating body must adopt a
wider perspective and comprehensive policy for planning the services, otherwise, it will not be effective. One of the obstacles for the development of the services for the elderly in Hong Kong is that individual government department does things in its own way. In view of the rather limited resources, we are in financial straits.
Therefore, this central body must co-ordinate the services for the elderly and pool the resources so that the care for the elderly can be more comprehensive and more effective on the basis of cost effectiveness.
Of course, in order to exercise its functions, the central co-ordinating body should be given adequate powers. If it only plays an advisory role, then its importance and co-ordinating capacity will be very limited.
Secondly, social atmosphere and family education
Maybe the society's attitude towards the senior citizens is more important. Hong Kong, as a Chinese society, used to have a profound and long-standing tradition of respecting the elderly. However, the rapid social development and the popularization of western ideas and values lead to disintegration of large families and deterioration of the relationship between the elderly members and the children. The concept of "treasuring the old members in our family" is gradually replaced by the idea that "the father takes care of the son who will then take care of his next generation". The elderly members in the families are now generally regarded as a burden. There have been cases where the family members gave false address when they sent the elderly to hospital and where the whole family migrated overseas leaving behind the elderly members.
Therefore, the Government must restore the respect for the elderly in our society. For instance, the way of living with the elderly members and the children's responsibility to support their parents should be important parts of family education to be promoted by the Government. The Education Department should also strengthen family education among students of primary and secondary schools, especially
concerning the respect for the elderly.
In fact, government departments and voluntary agencies, and even mass media, may consider organizing more activities involving the participation of the younger generation as well as the elderly. This will help to promote the respect for the elderly and reduce the generation gap.
Education, of course, is important, but the crux of the matter is "the unity of knowing and doing". We cannot simply talk about respect for the elderly and the most important thing is how to implement the idea of respecting the elderly so that the elderly can be really benefited. In this regard, the large corporations which are closely linked with the people's living, especially the public utilities
companies, play a very important role. Just as the same with environmental protection, if these large corporations can promote respect for the elderly and consider the needs and the welfare of the senior citizens when they formulate policies about their services, I am sure that they can play a leading and an exemplary role.
But unfortunately, many public utilities companies do not have a strong sense of respect for the elderly. They even have some sort of discriminatory policy towards the elderly, perhaps because the idea of respecting the elderly is not so trendy as environmental protection and is not a global concern. I would urge the large corporations in Hong Kong to take care of the senior citizens' welfare and needs when they think of ways to repay our society and establish a corporate image. The elderly, more than anyone else, deserve care and reciprocation by our society. Now I urge the persons-in-charge of the large corporations to take up their responsibility as corporate citizens so that people all around the world know that the large
corporations in Hong Kong really care for their society instead of only following the trend.
I have proposed on several occasions at the Transport Advisory Committee and the district board to set up a concessionary fare system for senior citizens. The system is not only designed to reduce the senior citizens' travelling expenses but also to acknowledge the social status of the senior citizens. If various strata of our society respect the elderly and recognize the status of senior citizens, the public transport companies, which pay much attention to their image, will eventually implement a concessionary fare system in view of the pressure from society and public opinion. Once a company takes the lead, the other companies will follow just like the case of environmental protection, which has already become a theme to establish corporate image.
Thirdly, housing needs
Now I would like to mention especially the housing needs of senior citizens and the serious shortage of housing units for them. There are rather limited places in the private homes for the elderly in Hong Kong and there is a serious shortage
of personal space. Therefore, the senior citizens who are neither rich nor poor are the persons who are neglected most. They are able to pay the monthly rents for a private home for the elderly and wish to have more personal space, yet they cannot afford the high rent of a private flat. In fact, as regards the land policy, the Government should encourage the construction of more spacious hostels for the elderly, especially residential institutions by non-profit-making agencies so that the senior citizens of the middle class can have more personal space.
In fact, as a result of the aging population and the changes to our social structure, more and more people have to live by themselves. A lot of them are unable to take care of themselves due to poor health or other reasons, therefore, they do need residential care in care and attention homes, infirmaries, homes for the elderly or hostels for the elderly.
At present, residential care is lacking seriously and the total number of places in these institutions only amounts to 12 000, which is far from meeting the actual demand.
Of course, we understand that the Government has only got limited resources. But in order to expand residential care for the elderly, one of the cost effective ways is to encourage the development of non-profit-making homes for the elderly. The greatest encouragement is to offer favourable and concessionary terms in granting land for building residential institutions. In fact, the Government may consider renting or selling some of the land which has been resumed by the Land Development Corporation to the non-profit-making agencies or operators at a concessionary price for building and running hostels for the elderly, homes for the elderly, care and attention homes and infirmaries.
Fourthly, a sense of satisfaction at being active upon retirement
How to make the senior citizens active and lead a richer life upon retirement is also our concern. The senior citizens have much experience in our society and their work and it is, in fact, a waste of social resources to let those who are physically and mentally fit idle about. I propose that a "consultative society of senior citizens" be set up in each community so that senior citizens from all walks of life can be grouped together. On the one hand, they can offer advice on district matters and public welfare whereas on the other hand, the other senior citizens can seek assistance from this consultative society whenever necessary. This can
generate some sense of satisfaction in their participation in community affairs.
Lastly, I would like to emphasize that it is the time for the Government to formulate overall and comprehensive policy for taking care of the elderly. This is not only due to the aging population in Hong Kong but also due to the fact that the clients of social welfare are getting old. We can no longer waste time indeed.
Mr Deputy President, with these remarks, I support the motion.
MR JIMMY McGREGOR: Mr Deputy President, I suppose I should declare an interest. I do not feel elderly, not in my twilight years, highnoon perhaps. I applaud the initiative of my friend and colleague Dr LEONG Che-hung in seeking to debate this most important matter. Despite all that has been done over many years of increasing economic growth and prosperity to provide a safety net for our aged, our handicapped and our disadvantaged, it is a fact that hundreds of thousands of old people have to depend upon an uncertain charity to keep body and soul together.
My colleagues in this Council are concentrating on an expansion and improvement of the various services which are now, or can be in future, made available to our senior citizens. I will not attempt to repeat any such proposals.
Instead, I wish to make the point, as I have done publicly, and in this Council, many times before that the greatest comfort and social security that can be provided to elderly people, and particularly those who have no family to depend upon, is an old age pension.
The Social Security Society and the Hong Kong Democratic Foundation have both produced proposals for consideration of such a pension, to replace the present rather parsimonious Old Age Allowance, and to be part and parcel of the wider study now to be carried out by the Government into the extension of private sector provident fund schemes.
I have no doubt that not only is an old age pension within our financial capability but also that it is inevitable. In most countries, such a pension is already in place and some of these countries are strong competitors to Hong Kong for world markets.
I have heard the 19th century voices of some people in Hong Kong raised against
the concept of an old age pension. These worthy people say that the Chinese, as a race, do not want to be given charity nor do they wish to have to depend upon the state for a pension, nor should they be discouraged from continuing to work long after the age of 65. Some legislators of this Council during the last 20 years or so are on record as supporting this strange philosophy that suggests elderly people should not be mollycoddled.
Mr Deputy President, I believe that it is nonsense! Hong Kong's elderly people are just the same as all other elderly people. They are entitled to the best level of social security that the economy can provide. An old age pension is certainly the central element in any modern social security system.
I understand the Government will include consideration of this proposal in its deliberations on the extension of provident fund schemes. I am very glad to hear it and I am sure that this Council and all who care about the dignity and security of the elderly will support this initiative and do their best to help the Government to reach sensible and affordable conclusions. Mr Deputy President, whether it is highnoon or twilight, I support the motion.
MRS ELSIE TU: Mr Deputy President, when I came here in 1951, Hong Kong was just entering its industrial revolution. Like all such revolutions in history, it was accompanied by all the evils of rapid industrial growth. A labourer's working day was 12 to 16 hours, seven days a week, with no holidays, sick leave, compensation for accident, or public assistance for those in need. Many people died of neglect. The overworked and underpaid of those days are the elderly people of today, and many of them are in need of care.
I wonder if Hong Kong's billionnaires who boast of our economic miracle have ever realized that economic miracles do not just happen. They come from sheer hard work, sometimes exploitation, and much of Hong Kong's success is due to those who are now elderly who worked so long and so hard for so little reward. Instead of feeling self-satisfied with our achievements, we should be hanging our heads in shame that we have failed so badly to take care of those who put their life's blood into our economy.
There are many ways of taking care of the elderly, and I am sure my colleagues will cover all other aspects. But I want to concentrate on only one, the housing
of the elderly, because I believe that is one of the basic necessities of life.
In the recent policy debate, the Secretary for Health and Welfare said: "We have just started a new scheme for single elderly persons who are in need of housing, particularly street-sleepers and bedspace apartment lodgers" (which is a euphemism for the caged men). The Secretary went on to say that "Hostels will provide
accommodation pending more permanent housing..... Seed money for this has been generously donated by the Royal Hong Kong Jockey Club." I am not blaming the Secretary, because she is fairly new to this post, but please notice her words, that this is a new scheme and that only temporary hostel accommodation will be funded from gambling activities. Is that the best we can do for the elderly, after 40 years of economic progress?
The recent White Paper on Social Welfare begins its chapter on services for the elderly by saying: "An elderly person should be assisted to live in his own community with dignity." I could not agree more. But my mind immediately conjures up scenes on television of elderly persons being evicted from condemned tenements, sad scenes that one might expect to see after some natural disaster. No one has bothered to tell these lost and bewildered old people what to do when the premises in which they have spent their lives are to be demolished. Several times in the past few months we have seen old people being turfed out of their homes, wondering where to go for help. Where is the dignity that the White Paper promises?
Of course we do have a policy for displaced tenants. They can have temporary housing in the New Territories. But the White Paper recommends and I quote that "Care of the elderly should be provided in the same neighbourhood so as to avoid the trauma of moving residents to unfamiliar surroundings." These are fine words. But
television pictures show a very different story. The elderly people go through a traumatic experience before anyone bothers to step in to help. Is it not possible that when demolitions for any reason are to take place, some investigation may be made into whether there are elderly people involved? Can they not be properly
rehoused as of right, in familiar neighbourhoods?
I now turn to the subject of priority housing for the elderly on the waiting list. I find that is an empty promise when the applicant is an elderly singleton. After waiting for years, applicants are told to share with one or two elderly persons, or continue to wait. They are also told that the only housing available is in the New Territories, usually Tuen Mun. This unreasonable policy of sharing is justified in
the Report of the Central Committee on Services for the Elderly, 1988, which claims that elderly people live together harmoniously and provide mutual care, and that only 14% of them have disputes when living in shared accommodation. Fourteen per cent means quite a lot of people, but even that does not tell the whole story. Many elderly refuse to accept housing when they are told to share; others accept, but when they find their co-tenants incompatible, they go back to the streets and passageways, or move from friend to friend with no fixed abode. Could that be construed as living with dignity?
The recommendation in the White Paper that the elderly should be provided for in their own neighbourhood is totally ignored not only by the Housing Department but also by some social workers, who have rationalized sending old people to the New Territories from the urban areas by suggesting that it is better for their health. I do not think elderly people will want to find fresh air by hill-climbing. I am sure they would prefer to shop in familiar places, exercise in familiar parks, and be near their friends and relatives or the churches and temples where they worship. As a person who studies sociology from people rather than from books or policies, I am amazed at the jesuitry of government departments in rationalizing anything that happens to suit their opportunistic policies.
Not only so, but in the Government, the right hand does not know what the left hand is doing. While the White Paper of March this year states clearly and I quote "the number of elderly living alone is anticipated to increase", the Governor in his policy address in October informed us that there will be a shortfall of singleton housing. So in planning flats, the anticipated increase in the number of singleton elderly living alone has been totally disregarded.
Coming to care and attention homes, I find that the situation is equally deplorable. I have been asking through various channels for the past two decades what is being done for those who cannot take care of themselves. In the early 1980s I was told by the Social Welfare Department that this problem would be solved by 1985. Now, six years on, we are told this problem will be settled in ten years' time. I hope I may be forgiven if I say that I will believe that when I see it happen. What comfort can an 80-year-old get from being told not to worry, his problem will be settled in ten years' time. Ten years' time is too late for an old person. I am aware that voluntary agencies have tried to make up for the Government's shortcomings, and that private homes can get certain assistance if they meet a standard that few of them can reach. But the waiting queue for care and attention homes is still years
long. I can find no excuse for this neglect on the Government's part.
In case I am told that all this neglect is a matter of priorities, I would like to seek the Government's advice on what it calls "priorities". The Government's list is very different from mine. Let me give a few examples to show how the Government squanders our money on non-priorities. Is it necessary to spend about $200 million on an escalator uphill from Central? Some people consider it a nuisance. Was it necessary to spend probably more than a billion dollars on the Housing Authority's extravagant new headquarters when the original building was reasonably new and
already considered to be well above standard? Even more obscene, or even unprincipled, is the provision at public expense of a luxury cruise for the not so elderly and not so needy civil servants on retirement necessary? In case I am told that this luxury was some obsolete condition of service left in contracts since the days of sailing ships, let me ask if it is also in their contracts that on retirement they may return to Britain first-class by air, then return to Hong Kong to join the luxury cruise? If these people feel nostalgic for the days of sailing boats, why not find them berths in freighters, or even in the Royal Navy? But why a luxury tour, why a luxury ship at about $60,000 a berth? Millions of dollars of taxpayers' money are being spent, not on the sick and the needy but on the rich and the greedy. Is housing for the elderly not on the Government's list of priorities? It should be.
The fact of the matter is that the urgent needs of the really needy, that is, the elderly, are being sacrificed to provide luxuries for the grab-alls. We must rid ourselves of this shame and get on with the job of providing for those to whom our economy owes so much. Just for once, can we get our priorities right? Mr Deputy President, I support the motion.
PROF EDWARD CHEN (in Cantonese): Mr Deputy President, before I speak, I have to declare my interest. I am the chairman of the Hong Kong Society for the Aged.
The aging of the population is a known fact, but the Hong Kong Government should have had a set of programmes in place much earlier. In 1972, a working group was set up to study the direction of the development policy for the elderly. Recently a White Paper Social Welfare Into the 1990s and Beyond was published, which contains detailed policy proposals and would probably be supported. However, the White Paper only emphasizes the quantitative increase in services for the elderly. Of course I was pleased to see there are some so-called "planning ratios" in the White Paper
up to a fairly reasonable level. For instance, now there is a fraternity centre for the elderly for every 3 000 old people, a day care centre for the elderly or a community service centre for the elderly for every 25 000 old people. At the same time, the number of beds in care and attention homes for the elderly has increased from eight to 11 for every 1 000 old people. This basically strikes a balance between
institutional care and home care. Regrettably, two problems still remain. The first is how to actually implement the policy concerning the elderly in the White Paper. Many voluntary agencies are now extremely concerned with this problem. They doubt whether with the present fiscal constraint introduced by the Hong Kong Government the proposals in the White Paper can be carried out. We know that of the problems of the elderly, taking care of them is only a moral obligation. However, it is also very important from the point of view of social interest, because the stability of society depends on our taking good care of the elderly. I therefore support what the Honourable Mrs Elsie TU said that the Government should review its priorities and should understand the importance of taking care of the elderly to society as a whole. Thus more resources should be allocated to services for the elderly. At the same time, the policy raised in the White Paper is also not comprehensive enough, mainly because the proposals concentrate only on what the Social Welfare Department can do. Of course, this is not because the working group did not work hard enough, but mainly because the terms of reference of the White Paper are confined to this respect. Services for the elderly are very complicated, which involve policy branches and government departments. Apart from the Social Welfare Department, retirement education involves the Education and Manpower Branch; how to make use of the working abilities of the elderly and so on are questions of community development of the Home Affairs Branch; the transport allowance involves the Transport Branch; of course the most important are questions involving the Hospital Services Department and the Department of Health. In these circumstances, I agree with what has been said by other Members, in particular Dr LEONG Che-hung and Mr David LI, that there should be an inter-departmental standing co-ordinating/working group to co-ordinate overall services for the elderly. Of course, to formulate an overall and comprehensive policy would have to take into consideration many aspects of services for the elderly. I shall speak on only one today. I would concentrate on one aspect, which some other Members have already touched upon, that is, how to strengthen the services for the elderly and enhance the use of resources through the "prevention is better than cure" approach. With regard to the enhanced use of resources in the services for the elderly, sometimes it is not a question of inadequate resources, but of how the resources are allocated to achieve maximum effective utilization. If many of the problems of the elderly can be prevented, thus saving
much care for the elderly eventually, the use of resources will be much more satisfactory.
In respect of services for the elderly, both social services and medical services are closely related to the health conditions of old people. With developed medical science today, though many diseases are no longer fatal, many chronic diseases continue to exist. Since life span is longer now, many old people suffer these chronic diseases longer, and thus social expenditure incurred in caring for old people suffering from chronic diseases would rise. Therefore basically the question of usage of resources must be solved. How to improve the basic health of the elderly so that medical expenses on them can be reduced, and thus more resources can be released for other aspects of services for the elderly? The present health conditions of the elderly may be said to be extremely poor, compared with the level of economic development of Hong Kong. According to government statistics in 1986, 40% of hospital beds were occupied by patients over 60, which demanded a high proportion of resources. A survey on the elderly by the University of Hong Kong also revealed that amongst 1 000 old people interviewed, over two thirds of them said their health was very ordinary/not good/very bad, and 80% of them said they were plagued by chronic diseases. Consequently, how to improve the health of the elderly is a most basic factor in improving the use of resources for services for the elderly. To improve the health of the elderly, I believe this has to start from primary health care. Many Members have already spoken on this question, but I shall raise two specific proposals. My two proposals are:
First, in respect of primary health care: to establish a government-funded Health Centre for the Elderly. At present many centres for the aged offer physical examination services, but only a very limited range of services at that. If the Government can use some resources to establish a Health Centre for the Elderly, it would be amply rewarded, because the Government would save much expenditure incurred when the old people fall ill subsequently. The Health Centre for the Elderly should carry out regular physical checks on the old people, and provide consultancy on their health. The Centre should promote elderly health education in various aspects, for example, old people should have good living habits, and should be taught to quit smoking, drinking and so on.
Secondly, to encourage a diverse range of activities in the life of the elderly. To maintain good health and to reduce the incidence of illness, it is most important to be happy and open; then good health will follow. The life of the elderly is now
very monotonous. According to results of a study conducted by the University of Hong Kong, when 1 000 old people were asked what they usually did and how they usually passed their time, 50% gave watching television as the first and second choices, which meant watching television was the most common way of passing time; 30% gave morning tea and eating breakfast as the first and second choices. So these are already the best choices to pass time! This shows that the range of activities of the elderly at present is very restricted indeed.
Furthermore, it should also be understood that the needs of the elderly are quite different. Nowadays the life span is longer, medical technologies are developed, the standard of education has been raised and technology in general has been innovated; the elderly fall into many different types. If a correct term is to be adopted, the elderly population is now heterogeneous. In this situation, what shall we do? I have two proposals:
First, to step up the diversification in services for the elderly. Services offered by homes for the aged and care and attention homes should be diversified to meet different demands of different types of old people.
Secondly, in order to make the life of the elderly colourful, the vigour of the elderly has to be enhanced. Here, just like many of my colleagues, I advocate strongly that the Government should introduce a transport allowance. As with foreign countries, old people over 60 should be issued with a kind of pass which entitles them to enjoy half fare in public transport. This is very important. The reason of my proposal is not that this would simply raise the status of the elderly, but it is in fact an economic investment. Economic investors say that if the vigour of the elderly is enhanced, they can move around which will benefit their mental and physical health. Their reliance on medical services will be reduced and hence expenditures. To the Government, it is a worthwhile investment.
To sum up, Mr Deputy President, I feel that services for the elderly are multifarious and inter-departmental. Therefore it is necessary to formulate an overall and comprehensive policy. I support the motion.
MR FREDERICK FUNG (in Cantonese): Mr Deputy President, the age profile of Hong Kong's population will change during the 10 years to come, which means that the overall tendency is towards an aging population. The proportion of old people over 60 in
the population of Hong Kong will increase from 13% in 1990, that is 748 700, to 15.4% in 2000, that is 974 500. Hong Kong has never practised social security and has no compulsory retirement fund or provident fund to safeguard the old people in their twilight years. Now faced with the aging of the population and the big hefty increase in the percentage proportion of the elderly, I feel it is time that Hong Kong should allocate resources and pay for the cost to remedy the situation, so as to protect the basic living of the elderly. Of course, the satisfaction of material living alone does not enable the elderly to live happily in their later life. The respect and care of the family are also extremely important. If these social policies are
implemented, they would enable the old people to develop their mind and body normally, and also would ease social problems as a whole. According to information available, over 70% or 80% of the elderly still live with their families, which means the traditional Chinese family concept is still alive, and has not yet disintegrated completely. It is therefore an important subject how to make the family play its full role. I think the Government should set up as soon as possible a Central Co-ordinating Committee on Services for the Elderly, to formulate detailed policies for the elderly and to co-ordinate the implementation of various services. Furthermore, at the right time, it should promote the concept of "Senior Citizens" which is emphasized by western countries now. The so-called "Senior Citizens" is another name for the elderly. As they have contributed to society, made their achievements, garnered varied experience, and accumulated wisdom, they really deserve the respect of society. This is because if they are respected and highly regarded, all sectors of the community will also give them preference in material and service terms, thus bringing benefits to them. Consequently I feel that the senior citizens policy should be implemented. This does not only promote the general practice of respect for the aged, but is also the expression of the lofty idea of "care for our parents, and love our children", which has the practical meaning of improving the material life of the elderly in order to achieve mental and physical health. I have seven proposals:
First, on the question of extra tax allowance for senior citizens. Many countries grant such allowance to the elderly, in particular those over 50. They still go out to work, but in fact they have to incur higher expenses than others, particularly those who have to receive medical treatment. I feel that they should have more money left with them. I have a feasible proposal to the Inland Revenue Department. At present the allowance for a single person is $41,000, and $82,000 for a married couple without children. Can we raise the personal allowance for a person of 55 years of age who still goes out to work by $20,000, in other words, up
to $61,000? When a person reaches 56 to 60, then add another $20,000, up to $81,000. For a person of 61 or above, add another $20,000 up to $101,000.
The second proposal relates to dependent parent allowance. To encourage filial piety and the responsibility to support parents, the Government should give these people substantive support. I therefore feel that the Government could well raise the dependent parent allowance in order to encourage people to support their parents and also to enable such people to save up more resources for family expenses.
The third proposal relates to transport allowance. Senior citizens are mostly retired with limited financial resources. The fares charged by public transport companies at present are not cheap, which are generally a heavy burden and enough to affect the social life of the elderly. I propose that for a citizen over 60, he/she should be entitled to be issued with a kind of half-fare concession pass, so that he/she can travel at half fare on MTR, KCR, trams, public buses and ferries. The above measure needs the support of all public transport companies. Consequently I hope that the Government can formulate a definite policy to incorporate the
preferential treatment of senior citizens mentioned above as one of the conditions of granting franchises, thus compelling public transport companies to do so when the policy is implemented. We estimate that usually the elderly are more active during non-peak hours, and this would not substantially affect public transport companies, in particular their profits.
The fourth proposal relates to housing allowance. I had presented my views on many occasions in respect of accommodating single-person and two-person families in public housing, which is a problem directly affecting the elderly. I consider that the Government should provide more rooms for single-person and two-person families, which should not be delayed any more. At the same time, to those elderly without support, a special policy should be drawn up to deal with them as a matter of priority. As a fairly large number of senior citizens with no or just a meagre income, now live in private housing, I therefore feel that to those over 60 and retired, the Government should, apart from old age allowance, pay them some living allowance, which should include rents and house maintenance.
The fifth proposal relates to the question of special access facilities for the elderly. I believe that it was due to the efforts of many organizations and voluntary agencies that the Government enacted an Ordinance in December 1983 which provides that buildings should have special access facilities for the handicapped; in other
words, within buildings, some special passages such as ramps and so on should be provided. Although some overhead footbridges are now fitted with ramps, I find that some others have not been so fitted, due to unsuitable locality or cost perhaps, to the inconvenience of the elderly and the handicapped. I propose that when the
Government considers designing overhead footbridges or similar structures, elevators should be installed.
The sixth proposal concerns medical treatment and health care for the elderly. We all know that the elderly are in particular need of health care and have a great demand for hospital and clinic services at present. In 1989 the University of Hong Kong conducted a survey of general out-patient services and found that although people aged 65 and over accounted for 8.6% of the total population, they made up 21.5% of the total number of general out-patients in government clinics; and in hospital
services, patients aged 65 and over made up 33.7% of the total number of in-patients. The Comprehensive Household Survey of January 1989 showed that medical consultations by those aged 60 and over far exceeds that of other age groups. At present, in spite of the half-price concessions granted to the elderly, yet in the Report of the Working Group on Primary Health Care recently published by the Government, it was proposed that random samples of out-patients aged 65 and over who had attended government clinics should be taken for physical checks. I think it is the right direction for the Government to take, but I do not agree with random sampling. Since elderly people over 60 are showing obvious signs of physical deterioration, the Government should conduct basic physical checks regularly for them in different groups, for example, once a year, so that any disease can be detected early. Such a preventive measure can relieve the pressure of clinics and hospitals in having to deal with emergencies frequently.
On the other hand, the electronic media should produce some programmes for the elderly. The present licensing conditions for television stations in Hong Kong provide that some information programmes, such as news, special reports on current affairs and so on must be produced, and there are also provisions for minimum broadcasting times and ratios. Television stations also produce some items especially for children, women and young people, for example, "Women Time" for women, but seldom for the elderly. I think when the Government issues or renews licences, there will be no harm in requesting the electronic media to produce some television or radio programmes exclusively for the elderly, to be broadcast or telecast in appropriate hours in the morning and the afternoon. I believe that as these programmes are not necessarily broadcast or telecast during prime time, it will not
affect the advertising revenue of the media; but to the elderly, those hours are their "golden hours".
To sum up, I feel that the policies for senior citizens proposed above are only part of the proposals to meet present urgent needs. In fact, confronted with the inexorable aging of Hong Kong's population, I believe that we must prepare in advance, instead of considering it when the problem becomes really acute. I hope that what I have just said will form only some principles and directions of long-term services for the aged, and it will actually rely on the collective thinking of the general public to provide more response. I am also appealing to the public not to treat care for the elderly as a concept, but it must be carried out in practice to show respect for the elderly, and to requite them for their contributions to the Hong Kong community during their young days. Based on the foregoing, I support the motion. Thank you, Mr Deputy President.
5.00 pm
DEPUTY PRESIDENT: We will take a break for 20 minutes.
5.23 pm
DEPUTY PRESIDENT: Council will resume.
DR SAMUEL WONG: Mr Deputy President,
An aged man is but a paltry thing,
A tattered coat upon a stick, unless....
Soul clap its hands and sing.
The motion advocates formulation of a policy on the care of the elderly.
"Care" comes in many forms. It may be no more than a routine provision of physical needs. It may include a genuine concern. It may go as far as compassion. But for our elderly to clap hands and sing it must include overall well-being -- physical, psychological, social, financial and spiritual. Care for the whole being.
Too often it stops at routine provision of physical needs. There was the case of TANG Kwok-wah who, at 77 years, was terminally ill. The Government has little provision for the terminally ill. Social Welfare gave him sponsorship to a private old people's home. They provided for his physical needs. He was placed on a bunk bed on a roof. He had a table and chair. Plastic corrugate kept the rain off. The occupant of the other bunk died. After eight months so did TANG. That lonely roof was his final home.
The White Paper: Social Welfare into the 1990s and Beyond, states that the broad objective of services to the elderly is to promote their well-being in all aspects of life. So the Government does aim that they all clap hands and sing. Its intentions are right. What then has gone wrong? What is the reason for the 600 annual suicides among our old people -- those that are so far from clapping hands and singing they would rather lay down and die. And many of those, sadly, have been forced into suicide by their own families.
Let us look at some of the weaknesses of the services for the elderly and see where they stop at routine provision of physical needs. It is perhaps significant that of the four pages in the White Paper on Services to the Elderly, one whole page is devoted to statistic.
I will start with "encouraging the care of the elderly by family members" since that is the only part currently awarded the title of policy. It is based on the precept of the majority honouring and respecting the elderly and accepting the family's responsibility to look after them. This is in the face of a report by the Hong Kong Council of Social Service, dated December 1989, which categorically stated that, because of various socio-economic changes since the second world war, the family is no longer regarded as the most suitable and legitimate institution to take care of the elderly. But even disregarding this dichotomy, the White Paper makes no provision for the minority who give a space to their elderly and ill-treat them.
The extent of abuse of the elderly in Hong Kong is contained in the report of a joint project by the Hong Kong Polytechnic and the Hong Kong Council of Social Service. It analysed abuses under 24 indicators ranging from being frequently assaulted, being burned on purpose, not being allowed to eat or drink, being forbidden to sleep, being forced to commit suicide and so on. The report found that about 5% of households having elderly also had potential abusers. From this one can deduce that some 40 000 elderly in families in Hong Kong today are at risk of being abused.
A comprehensive policy must, before assuming that the majority of households respect their elderly, make provision for ensuring that such elderly are not subject to abuse or abandon. Like the well publicized case of Mrs LEE HO Min-ching, who was taken to Macau by her son and daughter-in-law and deliberately abandoned there. She was found starving on the hydrofoil wharf. This sickening case is not isolated. Nearly 100 old people per month are abandoned in hospitals alone and there is evidence to suggest that cases of deserting the old are escalating.
The so-called brain drain results in widespread abandonment often because foreign immigration laws prohibit the accompaniment of their elderly relatives. So we hear of cases like the catholic priest, who returned one night to see some newspapers and sacks on his doorstep. He kicked them aside to find the bundle was an old man - - dumped. It later transpired the ones who dumped him were his own family.
Now let us consider those with no family. There are considerable numbers of old people who fled alone to Hong Kong more than 40 years ago and have lost contact with their families. Now in their old age they are found in poverty, poor health and loneliness. The 1986 bi-census reported about 11.5% of the elderly live by
themselves without family and are socially isolated and vulnerable. The survey report for the Street Sleepers Project stated that out of the 1 000 existing cases 88% of street sleepers were migrants and over 50% came to Hong Kong before 1949. Yet those very people who have to resort to the Street Sleepers Association for shelter are required to leave the premises and wander the streets from early morning to dusk even if they are ill. Strictly routine provision of physical needs only.
A rung of a ladder was never meant to rest upon, but only to hold a foot while the other foot goes up to a higher rung. In the last decade we have climbed several rungs, but we still have many more to go before our elderly clap hands and sing.
In 1978, 100 single old men were found living in Tsuen Wan in a decaying tenement block due for demolition. It was overcrowded, unhealthy, dangerous and disgusting. They were living in two foot by six foot cages. At the time official figures showed that there were 17 000 in similar conditions. Today we have what Government euphemistically calls 5 000 bedspace apartment dwellers. Changing the name does not alter their plight and in my book 5 000 or 500 is too many. A sound policy would have got rid of them years ago. Just recently a fire broke out in one of these caged dwellings and claimed five lives. I am surprised we do not lose more, since cooking is done with kerosene on stairwells piled with old newspapers,
mattresses and rags. Even if the stairs were not blocked, how many old people are fit enough to get down in case of fire? The fire hazards in these bedspace dwellings are terrifying.
The 100 old men of Tsuen Wan were lucky. Their dwelling was due for demolition. The media drew attention to their plight and from a shocked public some compassionate members formed a committee, which later became the now well-known charity, Helping Hand, and with the unprecedented help of some dedicated members of the Housing
Department, they had the demolition delayed for a month and rehoused all the men in agreeable ground floor accommodation in a temporary housing estate. The next day the building came down.
The moral behind that story is significant. Up to 1978 the situation had been going on for years within the knowledge of the Administration, who had the statistics when asked, but it took the compassion of members of the public to start to put things right and to initiate the concept of partnership with Government, which many people seem to think was created only last month. It has proved a most excellent policy.
Charities provide compassion in many ways. The probability of kidney disease increases with old age. Yet the general policy in Government is that dialysis, the rather expensive treatment for kidney disease, is not to be made available to the elderly. The government criteria do not include the senior citizens. They are picked out to die.
Now dialysis is just as effective in the elderly as in the young. So charities have been set up to serve kidney patients who come outside the government criteria. And that is where the compassion comes in. One day, when demand and technology pull down the price of dialysis, no doubt the government criteria will be broadened and more cases will be taken on. But when is "one day" and how many cases is "more"? These need to be defined. We need a quantified policy.
An important part of the care of the elderly is their financial support. Criticism of their meagre allowances is so widespread I do not propose to dwell on that aspect. I would, however, like to make one point of principle -- or should I say policy? Allowances can be paid to the elderly at 65. Some, after a means test, qualify for the special needs allowance and can draw up to $2,100 per month. Big deal!
Suppose they take a job -- in the words of the White Paper to keep their dignity
and to continue to participate in society, both socially and economically, for as long as possible. They find they cannot make more than $100 per month. The rule is that so far as they are drawing an allowance their total income cannot exceed $2,200. In other words, after the first $100, the rest of their earning up to $2,200 are in effect taken by the Administration.
Now this is not only debilitating, it is unnecessary, it is treating the elderly as a statistic. Why not let them earn up to a reasonable figure, say $2,200, before the restriction is applied? Then they would have motivation to participate in society economically, to the benefit of everyone. Their souls would be given a chance to clap their hands and sing. The cost, surely, would be negligible. It might even help the labour shortage.
I have talked about living as a senior citizen in Hong Kong; I would like to finish by talking about dying. Death of an elderly, who is shifted off in any direction as long as it is out of the way, is a paltry thing. Yet, in a hospital bed he may linger for months while 500 others could occupy the space; come in, have treatment and be discharged. Far more satisfying for the medical profession. I sympathize with the doctors in their dilemma. On the one hand they can heal many, on the other hand they can make little impact on just one. Yet they are committed to face it impartially.
I related the story of TANG Kwok-wah whose boarding was paid for, yet he was left languishing on the roof, isolated, to die alone. How many other TANGs are there? A spoonful of sugar to make the medicine go down is more important in dying than at any other time in living. I applaud another charity, the Keswick Foundation Hospice Care, which will begin next year. People will be properly trained to deal sensitively with those close to the end. Let us form a sound policy and sound partnerships to provide comfort for the living and the dying so that no one shall quote W B YEATS and say of Hong Kong "that is no country for old men" but rather a place where the souls of the elderly clap their hands and sing.
Mr Deputy President, with these remarks, I support the motion.
MR MICHAEL HO (in Cantonese): Mr Deputy President, today I am going to concentrate on the discussion of preventive health services for the elderly. This concept is not new but so far, the Government and the public have not been able to keep pace
with preventive health services nor do they realize that these services are closely linked with the health of the public. The ageing of the population and longer life expectancy is becoming a sustained trend. Medical expenses on the elderly will go up. Whenever the health of the elderly is discussed, the "illness" approach is taken invariably. This approach has led us into thinking and planning our services along the line of arranging medical consultation, treatment and provision of medicine to the old. My colleagues have just mentioned that the salt content in food should be reduced in order to avoid high blood pressure and that less cholesterol-rich food should be taken to avoid heart diseases. This is a typical approach aimed at avoiding illness. Such an approach has not been able to go beyond the confines of avoiding illness. This "illness" approach also demonstrates that we regard "health" as
equivalent to "without illness". In fact the definition of "health" covers wider ground than without illness or avoiding illness. Preventive health services should be extended and not just be limited to the curing of diseases. We should look into those unhealthy lifestyles, such as eating habits, rest, environmental and mental health. From a "health" point of view, we should not just take into account the treatment of diseases, but rather we should take steps to ensure physical and mental health. This should include improving the life-styles of the elderly, for example, to ensure they have balanced diet, enough rest, and to eliminate their worries and confidence crises arising from the deterioration of their physical mechanisms, which may further lead to their avoiding contacts with others and becoming withdrawn and morose. Other social factors such as their financial difficulties may also be a cause of psychological pressure on them. Judging from the infant mortality rate and the average life expectancy of the population, Hong Kong's health indicators are rather good. The advance in technology has led to the lowering of the mortality rate and to the prolongation of life for many. These of cause include our elderly. But this does not mean that they are healthy. Hence, apart from the mortality rate, the real health indicators we should look for should be "morbidity".
In actual fact, the health of the Hong Kong elderly people are not satisfactory. According to the findings of a study by two local academics on the elderly -- incidentally, I am going to use the same study findings just cited by Prof CHEN but fortunately I am going to cite some different details. Whenever the elderly people are asked of their health, most of them do not consider themselves as healthy. Many of them have to stay in hospital frequently or have to get medical treatment. As for their hearing, their eye-sight and their teeth, these are always ignored and their health state is even more unsatisfactory. More than half of the interviewees consider their hearing ability as average or tend to be bad. 75% of them consider
their eye-sight average or tend to be bad. Chronic diseases are also common. More than half of the interviewees have rheumatism. High blood pressure and spine problem also worry many elderly people. The study shows that their knowledge of mental health is inadequate. Some of them have unhealthy habits such as smoking, drinking and not having breakfast every day. Apart from physical health, their mental health should also be a matter of some concern. The studies disclosed that many of the interviewees spent most of their time, as has earlier been pointed out by Prof CHEN, in watching television and more than half of them felt miserable. Over 40% of them felt lonely. This is an indication of their mental health. What I have just mentioned is not a kind of sickness but obviously, these elderly people are not healthy.
To improve the health condition of the elderly, we must deal with several major issues, for example, health education and co-ordination of resources. On health education, many elderly people are stubborn and subjective. Some of the current "piecemeal" health education measures are basically not of any apparent help to them. We should have some tailor-made health education plans for the old people. We should through the mass media and other channels let elderly people and their families know how to improve their health and where to find and use available resources. On the co-ordination of resources, there should be a comprehensive review so that the present medical consultation, community health care, outreach service and other ancillary medical services, such as that of the clinical psychologist and dietician, can
complement each other. It is hoped that following such review, there will be more comprehensive, convenient and expedient health services. It is hoped that as what my colleagues have just suggested, an inter-departmental working party can be set up to provide more comprehensive health services for the elderly. This would meet government expectation in the promotion of welfare services for the elderly through community care. In this way, not only the physical needs of the elderly will be cared for but also the various psychological or emotional problems caused by illness will be addressed.
With these remarks, I support the motion.
DR HUANG CHEN-YA (in Cantonese): Mr Deputy President, Mr WONG has just now spoken on the preventive medical services for the elderly, now I would like to concentrate my speech on other medical problems that our elderly are facing in Hong Kong. First of all, I would like to make it clear that old age is in fact a stage in our journey of life, but it does not necessarily mean an inevitable approach of illness and
disability. Therefore, a range of well-established medical services for the elderly should not be just confined to preventive care or treatment of old-age diseases, it should also include the promotion and maintenance of physical and mental health of the elderly because both medical and social services are actually inseparable for the elderly.
In considering whether subsidy should be made to social centres for the elderly or concessionary transport fares be provided to the aged people, we have to understand that the implementation of such policies will actually reduce the depression, anxiety or even paranoia suffered by many elderly people because of loneliness and isolation from the society. Viewing from a certain angle, the limited provision of
recreational services by these social centres and the provision of concessionary transport fares apparently may not have any economic value. However, these services and measures will help us save a lot of resources and bring considerable benefits to the society as a whole.
In considering whether retirement benefits should be provided, we should also understand that a difficult and poor living environment would usually increase the opportunity of being infected with diseases or succumbed to those diseases which they should not have. This would not only increase the suffering of those concerned but it also means a bigger price to be paid by the whole society. In considering the provision of medical services to the elderly, we must also bear in mind that such expenditure will reduce much unnecessary disability among the elderly, and that in turn it will reduce the subsidy from Government for welfare purpose and in providing more hospital beds.
Therefore, in considering care for the elderly, we should not just concentrate on the cost effectiveness of any individual measure. Instead, we should take a more comprehensive and objective view in making proper assessment on their cost effectiveness.
At the present moment, the average life expectancy of the Hong Kong people is among the top ones in the world. It is 75 for men and 80 for female. People sometimes would quote these figures to indicate that Hong Kong people are more healthy than those in other areas. But they have neglected the serious medical problems behind these figures.
Factors like the lengthening of our average life expectancy, decrease in birth
rate and the brain drain of our younger population are all contributing to making the problem of aging population more serious. In 1991 we have 480 000 people over the age of 65 in which over 160 000 people are above 75 years of age. It is projected that the former will be increased by 50% and the latter even be increased by over 90% to reach some 300 000 by the end of the century. We understand that the demand for medical services in a certain area, in particular the demand for hospital beds, is in direct proportion to the number of residents over the age of 75. This means that in the coming decade, we will have to provide medical services to cater for the needs of twice the existing population of the old people. This is a serious problem and it is also an important obligation of the whole community to take care of our senior citizens.
Furthermore, the average life expectancy alone will not tell us the actual health condition of these elderly people. Chronic diseases among the elderly are very common and they are also often coupled with complications. If they are not provided with adequate medical treatment and care, their basic survival ability will be affected. The vast demand for care and attention homes has indirectly reflected the health problem of our elderly people. We now have over 8 000 people waiting for places in care and attention homes and this figure does not include those on the waiting list of homes for the aged.
In view of the seriousness of this problem, we cannot simply be satisfied with any superficial and glossy answers such as the number of hospitals scheduled to be completed. We have to raise further questions as follows. What problems do exist in our medical services for the elderly? What improvement measures are required? According to my understanding, there are at least the following problems in the
provision of medical services for our elderly:
(1) Inadequate beds: Insufficient beds in care and attention homes as well as sanatoria has become a public concern. On the other hand, attention should also be paid to the inadequate provision of beds in the geriatric wards. In reviewing the medical services for the elderly in 1986, the Medical Development Advisory Committee projected that we would need 2 500 beds in the geriatric wards. But up to the present moment, we only have less than 750 beds and some hospitals are even not provided with such wards.
The Government has been informing us time and again that no elderly people will be rejected because of a shortage of hospital beds. This statement seems to
be true. But we have to raise a question, that is, is it really appropriate to rush elderly people in and out of general wards when they are suffering from both acute and chronic diseases which could only be cured slowly? Will these elderly people be classified as "second class patients" in the general wards? Recently, we have received complaints from some elderly people alleging that they had been turned down for renal dialysis service. Does it reflect indirectly that our medical services for the elderly have not been placed on the top priority list?
(2) Lack of full co-operation among various disciplines of medical services: In curing old people, we cannot just rely on high-tech acute treatment. The things required are a comprehensive diagnosis and an assessment on their ability, rehabilitation service of geriatric unit in day hospital, transport service to and from hospitals, community care service and residential institution service. All these services have to be well co-ordinated. At present we find different institutions providing their own services. The senile patients have to visit different places for diagnosis and treatment and they are really tired to death. There is a lack of communication among various community services, institution services and hospital services. Due to the inadequacy of the ambulance service, some elderly people are deprived of certain services (such as services provided by geriatric unit in day hospital). All these services must be properly co-ordinated by those professionals who have devoted to medical care for the elderly. It is only then that our resources can be effectively utilized.
As far as medical care for the elderly is concerned, it may be more cost effective to allow admission of elderly patients to geriatric rather than general wards. The former arrangement may have the advantage of lowering the frequency of admission and shortening the period of hospitalization. In other words, resources will be saved and expenses minimized. The Administration should not hesitate to adopt this approach which is more in line with the principle of cost effectiveness.
(3) In the past decade, I have noticed the commencement of our preliminary development on geriatric specialist service. I am pleased to learn that some geriatrists have started to liaise with the Social Welfare Department and consider ways to improve the health assessment on the elderly before they are admitted to the institutions. These contacts will have positive effects on medical care for the elderly. In the past decade, it appeared that the Government has been wavering in the development of geriatric service, just like advancing two steps forward and pause for a while. Until now we only have geriatric wards in three government hospitals