08 July 2008

Social Issues & Problems in HK

Dr. C.H. Leong

* Based on a speech delivered to the YEG HK Society (Indian Society of Young Executive) on 08-07-2008

This year marks the 11th anniversary of the establishment of HK SAR. In these last 11 years HK had faced many ups and downs. We have had a possible political instability from the change of sovereignty. We had an assault of a massive global economic downturn and we had a massive blow from an unknown diseases---SARS. HK reported some 299 deaths. Luckily with the concerted effect of all of us -----the public, the Hong Kong Government, and the health care professional we have emerge a winner. Our economy is booming now. We have a recorded fiscal reserve, our health status is second to none, if we measure our life expectancy, for males it is almost 79 and females 84.

Yet under these glitters are many social issue that plague HK, this apparent affluent society, issue that need to be identified and resolved before we can proudly claimed to be a caring society.

I would therefore like to bring you through 4 issues among many, where I am sure must be dear to everyone’s heart. These are:

*Problems in facing the challenge of an ageing society;

*Maintaining our high standard medical care;

*Tackling poverty;and

*The issue of racial discriminations

Elderly Services

HK like most developed countries faces a rapidly ageing population. Today one in 8 is 65 year old or above, and by the year 2033, our elderly will be 25% of our population. One in four will be 65 or above. It may sound ironic. HK is said to have many adverse factors that are not conducive to health----polluted environment, stressful life style--- yet we have over 1000 centurions and they are living longer.

Yes, we should never take our elders as society’s burden yet no doubted it is a challenge, in particular are we doing our very best to allow them a quality “golden age living”?

Government spending on Elderly Welfare is by no means stringent some $30 billion is spent on welfare, and elderly service take over the lions share.

No elderly will be left unaccountable for. A Comprehensive Social Security Assistance scheme (CSSA) is available to all elderly with no income after a means test. They are also eligible for disability allowance, if any; rental subsidy if they reside in public housing, and other sundry allowance to support their daily needs. All elderly at the age of 70 are provided with an Old Age Allowance (commonly known as Fruit Money) on application. This amount to $ 700 + dollar per month; and government is reviewing the amount.

But is providing a subsistence allowance the be all and end all for caring for our elderlies? As an elderly myself I will be looking for at least 3 other things. Firstly elderlies of today are healthier, more educated than those of yester years. I will be looking for ways means to maintain an “active ageing”---to be active to catch up with societal challenges; to participate in the society perhaps even contribute back to the society. It is on this basis that the Elderly Commission is pushing for the concept of active ageing, through establishment of an Elderly Academy. We are using schools as platforms where the student of the schools will act as teachers and elderlies will be students. The result is that elderlies will be able to learn new things, like computer etc and is the proceed the spirit of intergeneration harmony will be realized. So far we have 32 such schools and 5000 elderly students. The plan is to double and triple the amount and extends this learning concept into university and tertiary educational institution.

It is a general believe and most likely true that our senior citizens prefer to age at home, to be able to enjoy their golden age with their own families. Regrettably this is not always easy. Facts are that the rate of elderliness relying on institutions is the highest in the world. This is understandable. Living quarters in HK are small, most living environment are not elderly friendly, -----small toilet with no handrails to accommodate wheel chair; slippery floors, inadequate lighting in common corridor, etc. Most young people have to work and leave the elderly unattended at home, and home or community help are inadequate. Yet all these are not unsumountable. The Elderly Commission is actively trying to promote these improvement through the cooperate of the Housing Authority. Public housing are now progressively upgraded to be elderly friendly. We are seeking to properly train elderly carers both in the form volunteers and formal carers so that they will be equipped with the basic skill to care for our elderlies both physically and mentally. Needless to say these skills will be upgraded from time to time to ensure that the carers are given the chance to progress up the professional ladder. I personally believe that elderly carers should be recognized so that this discipline, this profession can be developed. For as HK ages, such services will be greatly needed.

Irrespective of the drive to age at home, the day will come when our senior citizens will best be cared for in institutions, e.g. when they become physically trail or deteriorate brain functions. HK currently have some 700 elderly homes catering for elderlies of different degree of needs. Regrettably they are of varying standards. While government subsidize homes are of high quality, many privately run homes have standards that leave much to be desired. The dichotomy is that while there is a long queue for subsidized homes and the waiting for space allocation may well be 2-3 years, the private homes always have vacancies. How to balance this paradox will be the challenge for the government, and the society in the days to come. The standard of private homes must be up lifted through some form of incentivization. After all looking after our elderlies should be everybody business, not government prerogative alone.

Sustaining our Public Health Care

HK is blessed with one of the best, if not the best, public health care services. For only a mere $100/day everyone can enjoy the very high standard of health care and all its cutting edge medical advance technologies in our public hospitals. The government motto that “ No one should be denied of care because of lack of means” is being practiced to the letter, and this is all done through our very narrow tax based system. The irony is that with better public services there will be an ever-increasing demand. In short the problem of our public health care is that we are using a “finite financial resources to provide an infinite need and demand” and this will not sustain, at least not the very high standards. This is of course compounded by the fact that new technologies, new medications though more effective are much more expensive. Our ageing population adds very much to the burden. Elderlies tend to have more complicated illness that requires complex treatment. With the ageing population, dependency ratio will move rapidly to less people paying tax supporting more people that require health care services.

It is obvious that to maintain our revered high standards of public medical service, change are inevitable ----change in service delivery and change in financing formulation. Result from the government health care reform consultation, I believe, showed that the public realize that we need changes. Yet when it comes to introducing new financial options, un-comprising controversies exist. It is understandable, for any new funding options would mean more contributions, in one way or another from members of the public, and when is the best time “pick the public’s wallet”?

Yet we have to come to terms with some new funding options soon. Statistical projection in HK indicates that total health care expenditure will increase by 3.6 time between 2004 and 2033 while GDP will only grew by 1.7 times during the same period. In short health care expenditure will outstrip GDP growth by a wide margin

I personal would urge government to come up with a rational funding formula that will balance the concern of the public and yet will on a long term basis provide a sustainable financial support to our high standard public health care for the public to consider. Needless to say government must assure the public in no uncertain terms that its responsible on health care as a safety net will in no way be deterred.

I look forward to the public and in particular you as leaders to respond positively to government’s possible proposal so that any decision could quickly be taken on board.

Remember any form of contributory funding modalities will take time to mature but our health care delivery cannot wait.

Tackling Poverty

Health, or the lack of it, is invariably link with poverty. It might be said that the last few years have seen HK undergoing an economic boom. Figures have shown that even unemployed rate is an all time low. Yet under all these glitters are examples of many who are still struggling to make ends meet. The last few years have seen a rapid rise in inflation rate, the cost of our daily necessities, basic food is up by almost 50%, increase oil price is reflected in the fuel cost of public transport. All these means the discrepancy between the rich and the poor is all time high. It is indeed sad that in an affluent society of HK where our fiscal reserve are the envy of most, we do see quite a few elderlies for example collecting card board boxes and sell them for their daily bread.

Government has taken the initiative through the recommendation of the Poverty Commission to address these problems. There will be an extra month of CSSA as a bonus; those receiving OAA will be given a $3000 as a token Lai See; each household will be given an allowance of $1800 electricity fee and a health care voucher system will soon be in place---each elderly will be given 5 vouchers of $50 each for use in any private health care service he/she desire.

Regrettably this is only a scratch in the move to alleviate poverty, much more needs to be done, not just by the government alone but by the whole community working together---the business sector, the NGO’s.

Racial Discrimination

Ladies and Gentlemen, it would be fool hardly for me when discussing the problem of social issue if I do not touch one the issue of Racial Discrimination. Although over 95 % of our population, is ethnic Chinese, Hong Kong people have a long tradition of living in harmony with and respect for persons from diverse cultural background and ethnic origins. While there are occasional complaints and incidents among individuals, as a community the relationship between the Chinese majority and the ethnic minorities in Hong Kong has generally been peaceful and harmonious. The Government firmly upholds the principles of equality and, as policy, recognizes protection against racial discrimination to be a fundamental human right for all citizens.

It is against this background that the government has introduced the Race Discrimination Bill into the Legislative Council. I am given to understated that there have been some concerns over the coverage of the Bill, especially in regard to its application to Government; and over whether or not there is sufficient assistance for those members of the ethnic minority who require special support to facilitate their access to public services and their integration into society.

On the application of the new law to Government, the Administration has said in public, it will introduce an amendment to the Bill so that the relevant provision will read “ This Ordinance binds the Government”. This should help further clarify application and alleviate unnecessary anxieties.

As regard support services, we are aware that a wide range of government services are available, some for all members of the community and others targeted specifically at members of ethnic minorities who require special assistance. These include an enquiry and complaints hotline operated by the Race Relations Unit of Constitutional and Mainland Affairs Bureau and language training classes and special community development and community support teams funded by the Bureau. I understand that we also have a special weekly radio programme in Hindi, which is sponsored by the same Bureau. Other support services are also provided by the relevant Bureaux and Departments in the fields, for example, for education and employment. I agree that these may not be enough yet. I think we can all be reassured of the Government’s firm commitment to helping the needy among us and in fostering a harmonious society in Hong Kong. This can be demonstrated in the continuing efforts make in public education, in legislation and in provision of various support services. It was not too long ago that the Financial Secretary in his Budget Speech this year announced the planned establishment of four regional support service centers for ethnic minorities and increased funding for designated school, which cater to non-Chinese speaking students. These are just some new initiatives to augment existing services. I am sure that the efforts will continue.

It would also be up to all in the community to behest the Government to take legal and administration steps to ensure that all citizens are treated the same irrespective of race, sex, age, and religion beliefs, after the Bill is made with law.

I have been discussing with you some of the rather important social issues that face HK. These are in no way exhaustive. Ever since HK became part of China, it appears to me that any issue in HK will end up being politicized. This is expected in any process of democratization. Yet I would appeal to all in HK to forgo their political differences when we come to improving the daily livehood of the public and work for a common good. HK’s public deserve a genuine caring and harmonious society.