As Hong Kong enters into a new era, the Health and Welfare sectors, including the Department of Health, the Hospital Authority, the Social Welfare Department and over 170 subvented non-governmental organisations, stand ready to expand and improve our health and welfare services to meet the changing needs of the community and take up new challenges.
The first part of this Policy Programme describes how the Bureau, through the Department of Health and the Hospital Authority, will work towards meeting the increasing health care needs of the community by establishing new hospitals and clinics, improving the quality of patient care and reviewing the health care system to ensure the continued delivery of quality care and identify the most appropriate financing options for Hong Kong's health care services.
The second part of this Policy Programme sets out our policy objectives and practical measures to achieve our goals regarding the policy area of "Welfare". We will seek to meet our commitments by providing the most appropriate and effective services to the vulnerable and needy. With concerted efforts throughout the sector, and with public support, we are confident of attaining our goals so that people in real need will find that they live in a caring society.
The Policy Programmes will give the public a better understanding of Government's policies and work direction on the policy areas of "Health" and "Welfare". In that connection, I welcome any comments that members of the public may have.
(Mrs Katherine Fok)
Secretary for Health and Welfare
The Hong Kong Special Administrative Region (HKSAR) Government is committed to ensuring that it is open and fully accountable to the people of Hong Kong. Policies, aims and programmes must be clear to all so that the Government can be accountable for their delivery. With greater clarity of purpose and accessibility, the public can better assess our performance and help us improve our quality of service.
The Policy Programmes, which underpin the Policy Address delivered by the Chief Executive in October 1997, explain the objectives and ongoing work of each Policy Bureau and its supporting departments, as well as Department of Justice, Office of the Judiciary Administrator, Independent Comission Against Corruption and the Administration Wing of the Chief Secretary for Administration's Office, and their proposed new commitments for the coming year. They are set out in three sections:
The Bureau's objective is to safeguard and improve the health of the community. We seek to achieve this goal by:
The Bureau's objective is to improve the welfare of our community by helping people overcome their personal and social problems. We accept a special responsibility:
We seek to achieve these goals through a wide range of programmes based on the following principles:
To meet rising aspirations, we continue to undertake new initiatives to expand the scope and improve our quality of service. To enable us to provide a comprehensive range of services to cater for the needs of a rapidly ageing population, we have set up an Elderly Commission to help us in policy formulation and co-ordination of services. We have pledged to adopt a multi-faceted approach to look after the health, welfare, financial security, housing and psycho-social needs of the elderly. We will improve our direct services for the elderly and their carers and enhance our assistance to the vulnerable elderly under the Comprehensive Social Security Assistance (CSSA) Scheme.
Recognising the important role of the family, we will encourage and mobilise family support in caring for the young, the old and people with disability. We will render preventive and supportive services, including family casework, home help services, respite services for carers and family life education programmes. Planned improvements to the subvention system will enable the sector to become more flexible and be better equipped to deliver comprehensive, high-quality and well-targeted welfare services.
The requirements of the relevant articles of the Basic Law, as listed in the Annex, have been reflected in the Bureau's objectives.
The Bureau will continue to provide, expand and improve our health services and establish a regulatory framework for traditional Chinese medicine. We will also ensure that the general public will continue to have easy access to a high standard of medical and health service provided by qualified professionals.
As regards the policy area of "Welfare", articles in the Basic Laws directly relevant to the provision of welfare services are in the Annex. The Policy Programme set out in this document aims to implement these Basic Law requirements and enhance the efficiency and effectiveness with which welfare services are provided to the community. In accordance with Article 152, we will continue to participate in international organisations and conferences on welfare issues. In September 1997, we participated in the meeting of the United Nations Economic and Social Commission for Asia and the Pacific held in Seoul, South Korea to mark the mid-point of the Asian and Pacific Decade of Disabled Persons. In August 1998, Hong Kong will host the 11th Asia and Pacific Regional Conference of the Rehabilitation International to exchange views and share our experience with participating countries on the provision of rehabilitation services.
The Health and Welfare Bureau is responsible for the following major programme areas:
As a special exercise, the Bureau is also reviewing the subvention system and the related arrangements to monitor the delivery of welfare services for NGOs.
The Bureau is committed to enforcing all relevant legislation to ensure a high standard of public health protection.
We have in place legislation designed to ensure that the health of the general public is well protected. They cover the following areas :
In 1996-97,
In 1998-99,
The aim of the Bureau is to prevent and control the occurrence and spread of diseases in Hong Kong.
Hong Kong has an effective disease surveillance and control mechanism to keep communicable diseases in check. The surveillance system consists of a territory-wide network of hospitals, clinics and laboratories, closely monitoring the pattern of communicable diseases through case notifications and laboratory analysis. Surveillance findings are disseminated to health care professionals and the general public.
The control of communicable disease is effected through various designated units, which are responsible for health education and publicity, vaccination, food control and outbreak control. Specialised services have been established to control specific communicable diseases such as tuberculosis, sexually transmitted diseases and AIDS. The Institute of Pathology of the Department of Health provides the essential public health laboratory support.
In 1996-97,
The aims of the Bureau are:
There is a network of 73 general and 72 specialist out-patient clinics providing primary and secondary medical services to patients. In-patient services are provided by 40 public hospitals, with two more coming on stream in 1997-98. Dental services are provided to hospital in-patients and in emergency cases. All these services are provided to the community at heavily subsidised rates.
In 1996-97,
In 1998,
The aims of the Bureau are to increase health awareness in the community and among specific target groups and to improve the general health of the population.
The Department of Health provides a wide range of health education activities including exhibitions, workshops, dissemination of materials, and provision of training and support to interested parties. It produces health education materials covering over 350 topics and operates a counselling and telephone enquiry service on AIDS.
The Hong Kong Council on Smoking and Health seeks to discourage smoking and prevent smoking-related diseases by providing public information on smoking and health, and by conducting health education, especially among young people. We also have in place legislation designed to restrict tobacco advertising, prevention of tobacco sales to minors and establishment of non-smoking areas to discourage smoking.
In 1996-97,
In 1998-99,
The aim of the Bureau is to improve the quality of life of old people so that they can enjoy a comfortable and dignified old age. We seek to achieve this aim by offering services:
To help elderly people to live at home for as long as possible, community support services such as social centres for the elderly, multi-service centres for the elderly and day care centres for the elderly are established. Residential care services including infirmaries, nursing homes, care-and-attention homes and homes for the aged are provided to elderly people who can no longer be taken care of at home. Furthermore, the Social Networking for the Elderly project was launched last year to mobilise the public to show care and concern for the vulnerable elderly people.
To better co-ordinate policy formulation and monitor the delivery of services to the elderly by different Government bureaux or departments and public authorities, we have set up an Elderly Commission since July 1997.
In 1996-97, we provided:
Encouraging family support
Increasing supply and improving quality of subvented residential care services
Providing dedicated medical, health and social services
The aim of the Bureau is to encourage the integration of people with a disability into the community and enable them to realise their full potential.
The estimated number of people with a disability in 1997 is 369 000. We have been expanding various services, particularly day and residential services, to meet existing and projected demands. Upon the completion of several large rehabilitation centres including the Aberdeen Rehabilitation Centre by end 1997, we will achieve our target pledged in 1992 to provide some 7 300 additional residential and day places for adults with a disability by 1997. We are also on track to meet the target pledged in 1994 to provide an additional 737 pre-school places for children with a disability by 1998-99. As at end September 1997, we have already provided 557 additional places.
As regards legislative measures for protection of people with a disability and their carers, in June 1997 we enacted the Mental Health (Amendment) Ordinance 1997 which, amongst other things, provides an improved guardianship scheme for mentally disordered and mentally handicapped persons. Action is in hand to make the subsidiary legislation and appoint a new guardianship board.
In 1996-97, we provided:
In 1998-99,
The aims of the Bureau are :
We have been providing both developmental and remedial services to help children and young people at risk. To avert and relieve the stress to children involved in matrimonial disputes, the Child Custody Services Unit of the Social Welfare Department (SWD) provides intensive casework service on custody and guardianship matters and deals with referrals from family courts.
To combat child abuse, we have launched publicity and public education programmes to promote public awareness of the problem, co-ordinated multi-disciplinary efforts, and strengthened the skills of professionals to improve counselling, treatment and other supportive services for child victims and their families.
To help young people at risk, our services are delivered mainly through children and youth centres (CYC), outreaching social work, school social work and integrated teams. Through counselling and guidance, we seek to help young people tackle their emotional and behavioural problems. Socialisation programmes are also organised to enhance young people's interpersonal skills.
To rehabilitate young offenders, we adopt social work approaches and provide community based and residential services. Community Support Service Schemes are currently provided under a pilot project to help marginal youths and offenders to reintegrate into the school system or into the community through job placement. Two teams under the Against Substance Abuse Scheme help young substance abusers.
In 1996-97,
In 1998-99,
The aim of the Bureau is to preserve, strengthen and support the family as the foundation of our community.
To preserve and strengthen the family, we promote family life education, render direct services at family activity and resource centres, and provide training for parents and carers at the family care demonstration and resource centre. To support families in need, we provide child care services, child care centre fee assistance, family aide services and home help service. To help families in trouble, we provide family casework service, residential care service for children, clinical psychological services and services for battered spouses. We also provide adoption service and services for street sleepers and bedspace apartment lodgers.
To help facilitate integration of new arrivals from the Mainland into the local community, we provide post-migration services.
As at March 1997,
In 1998-99,
The aim of the Bureau is to meet the basic and special needs of people in financial difficulty.
The CSSA Scheme and the Social Security Allowance (SSA) Scheme are the two major vehicles whereby we render assistance to financially vulnerable members of our community. Greater public awareness of the Scheme, improved levels of benefits, changing attitudes towards receiving Government assistance as well as the prevailing economic situation all have an impact on the number of beneficiaries, and the public's expectation of the two Schemes.
As at end March 1997,
We are committed to ensuring that no one is denied adequate medical treatment through lack of means.
The 21st Century will see rising health care costs, combined with an increasing need for services from an increasing and ageing population.
Our challenge is to see that the health care system, including both public and private sector providers, continues to make available quality health care at a price that both the individual and the community can afford. To this end, we are undertaking a comprehensive review in 1998 of the health care financing system, which will include examination of how services can best be delivered and funded in future.
The 21st Century will also see the statutory recognition of Traditional Chinese Medicine (TCM) in the health care system. Through the establishment of a statutory regulatory framework and rising standards, TCM will attract greater support among the community. Hong Kong is strategically placed and has excellent potential to develop into an international centre for the TCM practice and industry.
In 1996, 631 000 people or 10% of the population were aged 65 or over. By the year 2016, we estimate that this number will increase to over one million, accounting for 13% of the total population. The provision of welfare services to an increasing number of senior citizens will be a major challenge for the Government and the community in the coming years.
The HKSAR will develop a comprehensive policy to take care of the various needs of our senior citizens and provide them with a sense of security, a sense of belonging and a feeling of health and worthiness. We will foster respect and concern for the elderly in the community. We will encourage families to care for their elderly members and we will provide support services to carers. We will ensure that future generations of elderly people have a secure old age by the prompt and effective implementation of the Mandatory Provident Fund Scheme and we will continue to provide financial assistance to those who cannot meet their basic needs. We will promote the physical and mental well-being of our senior citizens so that they can continue to contribute actively towards the community.
Our challenge is to integrate people with a disability into the community so that they can lead a productive, meaningful and independent life. The key to full integration of adults with a disability is employment. To help them find jobs, we will continue to implement the policy to improve employment and vocational rehabilitation services set out in the 1995 White Paper on Rehabilitation.
To ensure that people with a disability have equal opportunities to participate in productive and gainful employment in the open market, the Disability Discrimination Ordinance (DDO) has been in full operation since December 1996. The Equal Opportunities Commission (EOC) has also issued a code of practice on employment to help employers, employees, as well as the general public understand the employment-related provisions in the DDO. The EOC and the Bureau will review and improve, where necessary, the provisions of the DDO in the light of the EOC's operational experience.
Besides legislative measures, general public acceptance of people with a disability is essential for meeting the goals of equal opportunities and full participation. Intensive public education programmes on rehabilitation conducted since 1994 have achieved some positive results and we will continue our efforts in maintaining the impetus. Our ultimate aim is to develop a culture in which the public would be willing and take pride in accepting and employing people with a disability.
We trust that these measures will mean that the coming of the new century will mark a new era of opportunity and improved quality of life for people with disabilities.
NGOs funded by the Government will continue to be the main delivery agents of welfare services in Hong Kong. In 1996-97, about 90% of all direct welfare service were provided by 173 NGOs through Government subvention. This amounts to some $4 billion or 76% of the SWD's budget, excluding social security payments.
In 1995, we commissioned a consultancy study to review our subvention system. As a result and in order to enable NGOs to meet the high service performance targets expected, measures aimed at allowing greater flexibility in the use of resources by way of a fixed funding formula and increased management responsibility will be introduced.
Efforts are also being made to put in place a system to evaluate and monitor the performance of NGOs by way of output measures to replace the current mechanism which places emphasis on monitoring the actual resources used to provide social services. In collaboration with NGOs, we are developing a set of Funding and Services Agreements and "Service Quality Standards" for the different welfare services as objective yardsticks for service monitoring.
We will establish a Service Performance Unit within SWD to implement the service quality assessment system. To equip SWD and NGO staff with the nececessary management skills to cope with the enhanced responsibility, modern management training will be provided.
Chapter III : Fundamental Rights and Duties of the Residents
Article 36
Hong Kong residents shall have the right to social welfare in accordance with law. The welfare benefits and retirement security of the labour force shall be protected by law.
Chapter VI : Education, Science, Culture, Sports, Religion, Labour and Social Services
Article 138
The Government of the Hong Kong Special Administrative Region shall, on its own, formulate policies to develop western and traditional Chinese medicine and to improve medical and health services. Community organizations and individuals may provide various medical and health services in accordance with law.
Article 141
The Government of the Hong Kong Special Administrative Region shall not restrict the freedom of religious belief, interfere in the internal affairs of religious organizations or restrict religious activities which do not contravene the laws of the Region.
Religious organizations shall, in accordance with law, enjoy the rights to acquire, use, dispose of and inherit property and the right to receive financial assistance. Their previous property rights and interests shall be maintained and protected.
Religious organizations may, according to their previous practice, continue to run seminaries and other schools, hospitals and welfare institutions and to provide other social services.
Religious organizations and believers in the Hong Kong Special Administrative Region may maintain and develop their relations with religious organizations and believers elsewhere.
Article 144
The Government of the Hong Kong Special Administrative Region shall maintain the policy previously practised in Hong Kong in respect of subventions for non-governmental organizations in fields such as education, medicine and health, culture, art, recreation, sports, social welfare and social work. Staff members previously serving in subvented organizations in Hong Kong may remain in their employment in accordance with the previous system.
Article 145
On the basis of the previous social welfare system, the Government of the Hong Kong Special Administrative Region shall, on its own, formulate policies on the development and improvement of this system in the light of the economic conditions and social needs.
Article 146
Voluntary organizations providing social services in the Hong Kong Special Administrative Region may, on their own, decide their forms of service, provided that the law is not contravened.
Note
In addition, all Bureaux/Departments, as well as Department of Justice, Office of the Judiciary Administrator, Independent Commission Against Corruption and the Administration Wing of the Chief Secretary for Administration's Office, have joint responsibility for the implementation of the following articles:
Articles 11 (first paragraph), 16, 56 (second paragraph), 62(1) and (2), 64, 142, 148, 149, 150, 151, 152 and 153.
Policy Programme