The Business and Professionals Federation of Hong Kong (BPF) has published a report entitled TOWARDS LONGER PRODUCTIVE LIVING – ELDERLY AND END OF LIFE CARE IN HONG KONG.
The report points out that Hong Kong should aim to be an Age Friendly City and become a model to the rest of China and the World.
To achieve this, we call for a new mindset and strengthening of community care. Elderly should be redefined as the age group with an age expectancy of less than twenty years and high priority given to unlocking the economic and social potential of the 60/75 age group. Broadly speaking people in their 60s should no longer be considered elderly. Also, it is essential to differentiate between Elderly Care which is health related and Social Care. Treating all elderly care as social security works against the government policy of Ageing in Place.
Although Ageing in Place is established government policy, there remains an emphasis on hospital and residential based services which channels resources in the wrong direction. As a result, Hong Kong has more hospital beds per thousand and a far higher proportion of deaths occurring in hospital than our peers (90%). Despite our higher number of hospital beds per capita, our recent difficulties in coping with the surge in Summer Flu admissions is partially symptomatic of misappropriation of high-cost acute hospital beds for non-acute hospitalisation.
To drive changes and set out clear objectives and core priorities, one centre of authority is essential. BPF recommends that either Elderly Care policy be transferred to the Food and Health Bureau or that the Elderly Commission be placed under the Chief Secretary’s Office with greater Executive Power. Other areas of priority policy action include:
Enhancing Living Space
Elderly housing accommodation, particularly in the public sector, where most less affluent citizens live, is not fit for purpose for elderly living. Retrofitting existing Housing Authority estates with elderly facilities and ambulatory care facilities is a priority.
Shortage of competent and qualified care workers is the single greatest barrier to providing care in the community and the one most demanding early action and long term planning. Care work is the ageing world’s largest growth employment sector with a predicted regional shortfall of over 18 million professional caregivers. BPF estimates a Hong Kong shortfall of not less than 25,000 care workers over the next decade. A comprehensive manpower study, training facilities, qualification criteria and the promotion of voluntary care work are proposed.
The Role of Government
A clear and well publicised articulation of the role of Government both in providing services and in overseeing services provided is required. The long established model for healthcare policy that nobody should be denied access through lack of means should apply equally to elderly care.
In contrast to Hospital based and institutional care, Community Care has been starved of funds. A commitment of at least HK$100 billion over the next ten years is called for to enhance non-hospital based elderly care services and facilities, including upgrading infrastructure and increasing the workforce.
Dying in Place
Hong Kong ranks below most high income counties in Asia in the Economist Intelligence Unit’s 2015 Quality of Death Index. Government must promote dying in place, tackle bureaucratic barriers and plan extended hospice care facilities.
Engaging the Private Sector
Elderly Care is everybody’s business. The Private sector is a major supplier of care services and Government should engage with it fully to provide new services and technology.
For full report, please download.