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Friday, November 10, 2017, 18:01
Elderly crisis deepens as cross-boundary option ends
By Zhou Mo
Friday, November 10, 2017, 18:01 By Zhou Mo

Zhou Mo finds rising healthcare costs driven by stronger yuan are cited as most significant barrier to moving across boundary, exacerbating the sharp increase in number of over-65s in HK.

Living across the boundary used to be a popular option among elderly people in Hong Kong who had to endure years of painful waiting for a place at a local nursing home. 

A larger living space, lower cost of living and a better environment were among factors prompting local seniors to move to the Chinese mainland and spend their days there. 

However, in recent years the number of Hong Kong elderly people choosing to reside on the mainland has been decreasing.

Taking nursing care on the mainland, especially in such places as Shenzhen and Guangzhou, is increasingly becoming unaffordable for ordinary people

Wong Chi-keung, retiree

Appreciation of the yuan against the Hong Kong dollar has increased the cost burden for Hong Kong elderly people. Living on the mainland is no longer a cheap choice, as they are not able to enjoy the mainland’s social welfare services and must use their savings for daily expenses. 

The Hong Kong government launched the Guangdong Scheme in October 2013, offering an Old Age Allowance of HK$1,325 per month to eligible Hong Kong elderly people aged 65 or above who choose to reside in Guangdong province but a decreasing number of people draw it every year.

The Hong Kong Social Welfare Department said 14,600 people benefited from the policy in 2016/17, down 15 percent from the 17,194 recorded in 2013/14.

The number of Portable Comprehensive Social Security Assistance Scheme recipients has also declined. The scheme lets eligible CSSA (Comprehensive Social Security Assistance) recipients aged 60 or above continue receiving cash assistance at the monthly standard rate and annual long-term supplement if they choose to reside in Guangdong or Fujian provinces.

In 2015/2016, 1,733 people enjoyed the welfare — 25 percent fewer than the 2,304 in the year 2012/13.

Cross-boundary residential care

Hong Kong Jockey Club Shenzhen Society for Rehabilitation Yee Hong Heights (YHH) is a Shenzhen-based residential care service center backed by the Hong Kong Society for Rehabilitation, a charitable organization in Hong Kong.

It is one of the two places implementing the Pilot Residential Care Services Scheme in Guangdong. 


Launched in June 2014, the scheme provides an option for Hong Kong elderly people who are on the special administrative region government’s Central Waiting List for subsidized care-and-attention places at nursing homes to receive residential care services at YHH in Shenzhen or the Hong Kong Jockey Club Helping Hand Zhaoqing Home for the Elderly in Zhaoqing, west of Guangzhou, which is a member of the 11-city cluster in the Guangdong-Hong Kong-Macao Greater Bay Area.

As of Sept 21, 165 seniors from Hong Kong were living in the Shenzhen residential care services center, of which 116 were subsidized by the government. The remaining 49 were self-paid elderly.

The monthly fee for a place in a two-bed suite with comprehensive nursing care services is 7,350 yuan (US$1,108). The cost rises to 8,330 yuan if special nursing care services are needed.

“Taking nursing care on the mainland, especially in such places as Shenzhen and Guangzhou, is becoming increasingly unaffordable for ordinary people,” said 73-year-old Wong Chi-keung.

Wong lives in a nursing home in Dongguan, another city in the Greater Bay Area. He pays 3,000 yuan per month.

“Compared with Hong Kong, the living cost in Dongguan is lower. But you can only say so if you don’t see doctors. When you get ill and go to the hospital, the large amount of medical fees will immediately raise your expense to a high level.”

Lost connections

Apart from rising costs, a reduction in connections with the mainland is also keeping Hong Kong elderly people from going north. 

“Many Hong Kong people of previous generations came to the city from the mainland several decades ago. They have close links to the mainland and are willing to return there after retirement,” said Jackie Mok, head of YHH nursing home in Shenzhen.

“But those generations are gradually passing away. The new generation of elderly people who were born and grew up in Hong Kong prefer to stay in the city rather than moving to an unfamiliar place when they become old.”

Wendy Man, vice-chairman of Clifford Group, which owns Clifford Care Home for the elderly in Guangzhou, suggested mainland nursing homes further improve their professionalism in providing caring services and work on positioning their operations.

The diminishing enthusiasm for cross-boundary elderly care among Hong Kong seniors could mean the city will face a heavier burden in dealing with its aging problem, as its elderly population grows. The Hong Kong Census and Statistics Department says the number of people aged 65 or above comprised 16 percent of the population last year. The figure is projected to reach 36 percent in 40 years’ time. 

Professor Helene Fung Hoi-lam from Chinese University of Hong Kong, who researched aging issues in Hong Kong, said in her observation some of the elderly in Hong Kong are looking at low-living cost residences in Taiwan or Southeast Asia when planning their retirement. 

Noting the government’s initiatives in the newly released Policy Address, Fung said authorities have strived to make the aging care ladder easier to climb by assisting and funding community and household care. 

Hong Kong is a society with low tax rates, which makes it unrealistic to implement a fully fledged universal pension system, Fung said. 

In reality, the government has managed to provide more options for those with diverse needs.

“The government’s policy direction should accord priority to the provision of home care and community care, supplemented by residential care,” the Policy Address read. 

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Proactive approach

By Shadow Li in Hong Kong

In Chief Executive Carrie Lam Cheng Yuet-ngor’s maiden Policy Address, she expanded the voucher schemes for the elderly, especially those discharged from hospital to enjoy caring services at home. The vouchers, paid by the government, will let them enjoy a convenient and free service from local non-government organizations, saving family members much hassle. Those entitled to nursing home service vouchers will be able switch nursing home if they do not like the service. That is different from the original plan of funding the nursing homes, where money will be given and at their disposal and the residents have almost no say. 

The missing or a weak step in the elderly care ladder — home and community care service — has led to a vacuum. Those who could find their way through the confusing and complex home and community care service system would have to foot the bill with their disposable income. The government’s funding in giving out those vouchers, though a small amount, will create a difference, Fung said. 

Hong Kong’s limited land resources have unavoidably meant the city’s aging problems need better solutions than simply building more nursing homes and elderly facilities. Multipronged solutions with an “innovative thinking and approach”, as the Policy Address puts it, need to be in place as the population ages faster. 

Also, as in every crisis humans have faced in history, technology is expected to be the panacea for aging. The government will earmark HK$1 billion to help nursing homes procure new technology to cope with manpower constraints. That, in Fung’s opinion, constitutes part of the multipronged measures and is in a right direction to solve the aging issue. 

Some nursing homes in the city have heeded the government’s call to adopt innovative technology to overcome their staff shortages. Some installed an alarm system which alerts caregivers once the diaper of the bed-ridden patient is full. Some also introduced robots to help their early-stage dementia sufferers maintain their cognition and improve the efficiency of staff.

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