MESSAGE

         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


INTRODUCTION

         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:



Objectives


Health

         The Bureau's objective is to safeguard and improve the health of the community. We seek to achieve this goal by:


Welfare

         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.


Implementing the Basic Law

         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.


Back to INTRODUCTION


Major Programme Areas

         The Health and Welfare Bureau is responsible for the following major programme areas:


I. Health

  1. Public Health Protection;

  2. Prevention of Diseases;

  3. Curative Care; and

  4. Promotion of Health.


II. Welfare

  1. Caring for the Elderly;

  2. Meeting the Needs of People with a Disability;

  3. Helping Children/Young People at Risk and Young Offenders;

  4. Supporting the Family; and

  5. Providing Social Security.

         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.



I. Health

A. Public Health Protection


Aim

         The Bureau is committed to enforcing all relevant legislation to ensure a high standard of public health protection.


Overview

         We have in place legislation designed to ensure that the health of the general public is well protected. They cover the following areas :


Key Indicators

         In 1996-97,


New Commitments

         In 1998-99,

  1. We will introduce legislation to provide for the establishment of a statutory framework to regulate the practice, use and trading of Chinese medicine.

  2. We will review the Pharmacy and Poisons Ordinance to bring it up-to-date and to make its provisions easier to administer.

  3. We will review the Dental Registration Ordinance to bring it up-to-date.

  4. We will introduce legislation to regulate the practice of reproductive technology.



  5. B. Prevention of Diseases


    Aim

             The aim of the Bureau is to prevent and control the occurrence and spread of diseases in Hong Kong.


    Overview

             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.


    Key Indicators

             In 1996-97,


    New Commitment

    1. In 1998-99, we will strengthen our team of expert staff for the prevention and control of communicable diseases and take a more active role in global surveillance and monitoring of disease patterns. These efforts will enable the Department of Health to obtain more timely information on seasonal disease trends and to give timely health advice to the community.



    C. Curative Care


    Aims

             The aims of the Bureau are:


    Overview

             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.


    Key Indicators

             In 1996-97,


    New Commitments

             In 1998,

    1. We will provide an additional 754 hospital beds and 40 day places. To meet projected requirements, we will continue to make plans for new hosiptal services and for redevelopment and refurbishment of existing hospital facilities.

    2. We will provide additional consultations for the evening and public holiday clinic services and open a new general out-patient clinic in Kowloon Bay.

    3. We will establish an integrated day treatment centre for patients with skin diseases, sexually transmitted diseases or HIV/AIDS in Kowloon Bay.

    4. We will set up a radiography centre at the Kowloon Bay Health Centre which will handle 27 000 cases a year.



    D. Promotion of Health


    Aims

             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.


    Overview

             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.


    Key Indicators

             In 1996-97,


    New Commitments

             In 1998-99,

    1. We will enhance health promotion programmes to advocate self-care and a healthy lifestyle, to delay on-set of chronic illnesses.

    2. We will implement the new anti-smoking measures which have been provided for by legislation.



    II. Welfare

    E. Caring for the Elderly


    Aim

             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:


    Overview

             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.


    Key Indicators

             In 1996-97, we provided:


    New Commitments

    Encouraging family support

    1. We will establish 12 visiting health teams in 1998-99 and another six in 1999-2000 to provide preventive and promotive care services to the elderly living in the community and support services to their carers.

    2. We will establish 15 additional home help teams in 1998-99 to provide assistance to the elderly living with their families in the community.

    3. We will set up two Carers' Support and Resource Centres in 1998-99 to provide support and training to carers of the elderly.

    4. We will provide additional personal care workers in day care centres for the elderly to improve services to the demented elderly, and extend opening hours to cover Saturday afternoons.

    5. We will conduct a review on home help services to explore the feasibility of developing a more effective service.

    Increasing supply and improving quality of subvented residential care services

    1. We will increase the number of subvented residential care places under an enhanced Bought Place Scheme by 2 400 places in the three years 1998-2001.

    2. We will train up by a blister programme 270 enrolled nurses in 1998-2000 to serve in residential care homes and other facilities.

    3. We will provide resources to enable 23 large residential care homes to employ experienced Physiotherapists.

    4. We will create a new rank of Physiotherapy Artisan to enable Physiotherapists to make better use of their time for the benefit of their clients.

    5. We will introduce a new Dementia Supplement for subvented residential care homes.

    6. We will explore the possibility of implementing the concept of continuum of care by developing a prototype of home that can look after elderly people of different degrees of impairment.

    7. The Elderly Commission will assess the demand for residential care services and recommend a strategy in 1998 to meet the long term needs.

    Providing dedicated medical, health and social services

    1. We will set up 12 Elderly Health Centres with integrated services in 1998-99 and another six in 1999-2000 to provide preventive and curative medical services to the elderly.

    2. We will establish one additional psychogeriatric team to enable the provision of early diagnosis and intervention service as well as quality care in rehabilitation.

    3. We will set up 36 integrated teams in all existing Multi-service Centres for the Elderly and new centres coming into service by March 2001 to provide dedicated social networking and outreaching services to vulnerable single elderly.

    4. We will establish one additional community geriatric assessment team to provide pre-admission assessment to applicants for subvented residential places and provide outreaching specialist medical support to the subvented residential institutions.

    5. We will introduce an Elderly Volunteer Programme to encourage the elderly to contribute and participate as active members of the community.

    6. We shall provide additional family caseworkers in family services centres to provide counselling and casework services to help those elderly with depression and suicidal tendencies.

    7. We will explore the possibility of Social Centres working closely with relevant government departments in providing recreational programmes for the elderly.



    F. Meeting the Needs of People with a Disability


    Aim

             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.


    Overview

             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.


    Key Indicators

             In 1996-97, we provided:


    New Commitments

             In 1998-99,

    1. We will provide six additional aftercare workers to look after ex-mental patients discharged from halfway houses.

    2. We will provide 40 additional residential places, and 50 additional places in day activity centres.

    3. We will provide seven-day instead of five-day week residential service for four hostels for severely physically handicapped persons.

    4. We will provide 120 places in early education and training centres for pre-school age disabled children, and an additional 48 places for disabled pre-schoolers in integrated child care centres and 36 places for autistic children in special child care centres.

    5. We will provide five additional vehicles to meet the increased demand for scheduled-routes and dial-a-ride Rehabus service.

    6. We will provide a new skills centre in central Kowloon with 156 places and over $6 million to improve the accomodation and equipment of the existing skills centres.

    7. We will create four Senior Physiotherapist/Occupational Therapist posts to provide the necessary supervision and training to the junior therapists so as to improve the services for people with a disability.

    8. We will sponsor $8 million for hosting the 11th Rehabilitation International Asia and the Pacific Regional Conference in Hong Kong in August 1998.

    9. We will provide $4 million in 1998-99 and the same amount in 1999-2000 for public education programmes to promote the acceptance of people with a disability by the community.



    G. Helping Children/Young People at Risk and Young Offenders


    Aims

             The aims of the Bureau are :


    Overview

             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.


    Key Indicators

             In 1996-97,


    New Commitments

             In 1998-99,

    1. We will introduce mediation service in the Child Custody Services Unit to help divorcing and separating couples resolve disputes over matters of child custody or access.

    2. We will extend the Community Service Orders Scheme from the Magistracies to District Courts, Court of Appeal and Court of First Instance.

    3. We will provide funds to continue the existing Community Support Service Schemes on a permanent basis, by creating one team in the SWD and two teams to be run by NGOs.

    4. We will create one more outreaching social work teams to identify and help young people at risk.

    5. We will provide 14 additional school social worker units to serve 22 schools with more student problems.

    6. We will launch a pilot project in selected schools to further refine a screening tool for early identification of students at risk so that intervention can be provided.

    7. We will establish two "youth mobile teams" as a pilot project to help young night-drifters.



    H. Supporting the Family


    Aim

             The aim of the Bureau is to preserve, strengthen and support the family as the foundation of our community.


    Overview

             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.


    Key Indicators

             As at March 1997,


    New Commitments

             In 1998-99,

    1. We will enhance family services and post-migration services to new arrivals from the Mainland by providing more family social workers.

    2. We will strengthen family services by providing more family social workers.



    I. Providing Social Security


    Aim

             The aim of the Bureau is to meet the basic and special needs of people in financial difficulty.


    Overview

             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.


    Key Indicators

             As at end March 1997,


    New Commitments

    1. Starting from 1 April 1998, we will combine the annual Chinese New Year Grant and Social Recreation Activities Grant for the elderly under the CSSA Scheme and increase the rate substantially from an annual amount of $550 to a monthly payment of $380. All elderly in need receiving CSSA will receive the additional payment.

    2. We will ensure the provision of a quality service to elderly CSSA and SSA recipients by enhancing the staffing of Social Security Field Units within the SWD District Offices by creating about 100 additional posts in 1998-99.

    3. We will complete our review of the Social Security Allowances and related issues in 1998-99 and obtain the views of relevant parties prior to implementation.

    4. We will complete by summer 1998 a study to examine the operation of the CSSA Scheme and to make recommendations on how those on CSSA can be encouraged and helped to re-join the workforce.


    Back to INTRODUCTION


    Into the 21st Century


    Health

             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.


    Welfare


    Care for the elderly

             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.


    Integration of People with a Disability

             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.


    Improving the subvention system

             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.


    Back to INTRODUCTION


    Annex : Relevant Articles of the Basic Law


    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.


    Back to INTRODUCTION



    Policy Programme