Look No Further, Look North: Better Elderly Care Policies in the GBA

[Publication Pending]

She never wanted to stay in a residential home. But in her final days, my great grandmother, aged 104, was sent to one as that was the only option available. I vividly remember the reeking ward I visited almost daily and saw with my own eyes, mistreatments to elders drooling or choking on mucus, helplessly waiting to be helped. I was frustrated at the staffs for being sloppy, only to find out it is not their fault. Shortage in manpower and other resources, is why our elders live in these situations.

For too long, our city has been stretching scarce resources for a quickly expanding chunk of the ageing population. Lack of land and manpower are two recurring themes in this policy domain. Collectively as a city, we need to ask ourselves have we done everything we can for our elderlies?

Elderly Care is No Single Issue

In a paper submitted to the Legislative Council last year, the Elderly Services Association said the industry is at least lacking 5,000 front line staffers to serve in both community and residential care.

The issue is recognized by the administration but efforts to tackle it usually lead us back to a dead-end. The Navigation Scheme for Young Persons in Care Services did not produce the much-needed ‘new blood’. A reply to LegCo question revealed as at end-December 2018, out of the 1,018 trainees, 417 had left before completing training. More recently, a 350 million pay rise paid by the administration in 2019 was unable to close the gap in elderly service vacancies. Instead, after the pay rise, vacancies rose by 1% across all elderly care services.

On top of the manpower issue, we also can’t squeeze an inch for new elderly homes. As of 2020, total number of subsidized elderly homes and nursing homes stands under 29,000, merely 5000 more than 2008 numbers. The stagnation of subsidized homes for elders, some believe, is because elderly facilities were taken out of town planning in the early 2000’s and only until recently in 2017, they were put back into town planning guidelines. But it is already too late. At this rate, new homes will never catch up with elders in need.

Greater Integration with GBA Already Happening

While the government continues to find a way out, some Hongkongers took matters to their own hands. In recent years, number of seniors opting cross-border retirement is on the rise as more long-term care homes managed and owned by Hong Kong investors are available. To call these facilities ‘care homes’ are not entirely accurate as some of them are buildings with 24-hour clinics, Chinese herbal therapy parlors, recreational facilities and more. These one-stop services facilities are unimaginable in Hong Kong given spatial restraints.

Hong Kong retirees and elderly industry investors are very welcomed in the GBA, in fact the Outline Development Plan for the Guangdong-Hong Kong-Macao Greater Bay Area published in 2019 mapped out a blueprint for greater collaboration in social security and elderly care was front and center in that document.

More Inclusivity for GBA Retirement Option

But bear in mind, retiring in GBA is an option only for those who can afford it. Over half of the 1.16 million elderlies in Hong Kong are claiming Higher Old Age Living Allowance, while over 40,000 elders are on the wait for government subsidized residential care services. These needy elders cannot be expected to pay over 10,000 HKD per month to live in the GBA despite the price is 20% lesser than in Hong Kong.

With open arms extended to us from the GBA, we have to change current piecemeal manner on elderly policymaking. Concrete suggestions have been made on how to speed up welfare integration. For starters, the administration should consider expanding the scope of subsidized residential care services to those in the GBA owned and managed by Hongkonger to shorten the waitlist.

On the issue of medication, the administration should also study the possibility of allowing more GBA clinics and hospitals to use Health Care Vouchers (HCV). Currently, in GBA, only the University of Hong Kong — Shenzhen Hospital accepts HCVs, which is insufficient if we want to encourage more elders to retire up North. With the gap in medical technology and quality narrowing between us and the GBA, most of these facilities provide high quality medical and care services that can level with Hong Kong hospitals.

Another obstacle bugging retiree in the GBA is the claiming of insurance payments. Current policies forbid claimants from receiving payments out of Hong Kong. This generates unnecessary travelling which might is inconvenient to elders residing in GBA. Should this restriction be lifted, it would nonetheless incentivize more retirees to choose a life in GBA.

Society Calls for Decisiveness and Speed

To use a cliché, elderly issue is a ticking-timebomb and we must act decisively to avoid a population crisis. The above proposals are nothing new, they have been brought up time and time again by concern groups and the industry. With support from mainland and their abundance of manpower and land, on our part in Hong Kong, we must thrive and act more decisively.