(1) Opposition to giveaways; resources should be allocated to long-term policies and measures, as well as establishing long-term carer policies
The Tai Po Carers' group ("the group") believes that measures such as distributing consumer vouchers do not effectively utilize community resources to support those in need. Resources should be used to address deep-seated social issues, such as improving public healthcare services and the quality of facilities, as well as establishing long-term carer policies and services.
Currently, the carers' support measures in the policy address mainly individual services and projects, providing fragmented support that only benefits certain types of carers. We suggest establishing a clear positioning, concept and comprehensive plan for carer-based policies.
(2) Improving the quality and regulation of facilities
The quality and regulation of facilities have been criticized by society for many years. The group believes that many carers and care recipients refuse to use institutional services primarily due to poor facility quality. Carers are unwilling to let their family members suffer or face criticism from friends, relatives, and society (such as being deemed unfilial or irresponsible), so they shoulder the caregiving responsibilities alone, leading to physical and mental exhaustion. There are various reasons for the poor quality of facilities, but the group believes that the most important factor is the government's unwillingness to allocate sufficient resources to improve aspects such as per capita space in facilities, staffing ratios, and facilities to a reasonable and humane level. In this situation, regulation can only "comply" with service quality under limited resources.
(3) Improving aging-related technology
The group believes that the development of aging-related technology can benefit many carers. However, many current aging-related devices still face technical or operational difficulties that do not align with actual usage scenarios, resulting in limited reduction of caregiving manpower and labor. For example, turning beds may not effectively assist patients in turning over, ultimately still requiring manual assistance, which offsets the intended benefits.
(4) Focusing on the quality and support of elderly care in the Greater Bay Area
This year's policy address mentioned the expansion of several elderly care measures to the Greater Bay Area, including elderly medical vouchers and relaxing the "Guangdong Residential Care Services Scheme." The group believes that relevant policies should consider the medical and economic environments in both regions and make corresponding adjustments to facilitate development. This includes: 1) Linking the amount of medical vouchers to the difference in medical expenses between the two regions, ensuring that elderly individuals in the Greater Bay Area receive equal access to medical services. 2) Ensuring that elderly individuals from Hong Kong who reside in the Greater Bay Area continue to enjoy the same government healthcare safeguards, such as outpatient services and subsidized dental services for the elderly. 3) Reviewing and improving regulations on the quality and oversight of elderly care facilities in the Greater Bay Area.
(5) Improving public healthcare services
In terms of public healthcare, it is recommended that the government allocate more funds to acquire and improve public healthcare facilities and services. This includes increasing healthcare personnel, expanding hospital space and bed capacity, thereby reducing wait times for emergency rooms, outpatient services, and specialized clinics, as well as improving the environment in hospital wards. Overall, these measures aim to enhance the quality of public healthcare services.
- Reducing emergency room, outpatient, and specialist waiting times to ensure timely treatment for care recipients
Carers have expressed that both the phone and HA GO application for general outpatient appointments are often fully booked. When assisting care recipients in making appointments, carers need to concentrate on the application, waiting for available slots. In some cases, they are unable to secure appointments within the required timeframe, resulting in inadequate treatment for the care recipients. The appointment process puts significant mental pressure on carers. Additionally, the waiting times for more specialized tests like MRI or specialist consultations can stretch up to a year or even several years. This leaves individuals relying on primary care services and hoping that their condition does not worsen during the waiting period. Others may have to deplete their savings to seek treatment in the private healthcare system.
- Lowering the eligibility age and implementing universal dental care services for the "Elderly Dental Care Subsidy" scheme
The group suggests expanding the eligibility age for beneficiaries to start from 60 years old, as dental issues often arise around that age. Carers face significant financial pressure during the age range of 60 to 75 when dealing with dental problems due to limited financial resources. The high cost of dental services often leads carers to forgo seeking treatment, resulting in more severe dental problems. The group recommends reducing the service fee and decoupling it from the Elderly Dental Care Subsidy program, the Community Care Fund's dental care subsidy program, and other Social Welfare Department long-term care services. As dental services are expensive and crucial for long-term health, the group suggests the government expand public dental services to be accessible and affordable for all citizens.
- Considering Public healthcare services with carer-friendly perspectives
Carers have expressed concerns that government emergency rooms and inpatient services do not consider the needs of carers. For example, emergency rooms lack electronic systems to notify service recipients about real-time waiting conditions. Carers and care recipients have to endure long waits in cold emergency rooms, making it difficult to have meals or rest during the waiting period. In the case of inpatient services, children's wards lack beds for carers, forcing them to spend nights sitting on chairs beside the patient's bed. The physical and mental exhaustion experienced by carers while accompanying care recipients using public healthcare services is significant.
- Improving healthcare electronic systems and telemedicine
The advocacy group believes that significant improvements to current healthcare electronic and online service systems are crucial in reducing the stress on carers and care recipients. The government should promote telemedicine more extensively, allowing regular and straightforward follow-up appointments to be conducted through online video conferences. This reduces the travel and waiting time for carers and care recipients at hospitals. Medications can be arranged for expedited or postal delivery, and consultations with pharmacists or nurses can be conducted via video conferences for inquiries. For more complex cases or treatments requiring personal attention, home visits by healthcare professionals can be arranged. Volunteer organizations like the Care and Support Team can also assist in teaching carers how to use online systems for appointments and video conferences. Each party can contribute their respective roles.
Furthermore, carers have mentioned that adverse weather conditions have affected their and their family members' follow-up appointments. The public healthcare system does not automatically update follow-up dates and times for care recipients. Carers have to call the specialist clinics to reschedule appointments but often face difficulties getting through on the phone, adding to the mental burden of managing healthcare arrangements and increasing the workload for carers.
(6) Improving the Quality of Respite Care Services
One of the government's measures in public administration services is to expand the network of respite care services. The plan is to utilize around 140 vacant places in the "Enhancing Bought Place Scheme" elderly homes, approximately 20 places in privately-run homes for persons with disabilities under the "Purchased Place Scheme," and around 190 service units participating in the "Elderly Community Care Service Voucher Scheme" to expand the network. The advocacy group has raised concerns regarding whether these plans will provide real-time reporting of available vacancies and their numbers, as well as whether these homes will actively cooperate with the government in responding to community needs. These doubts are raised. Additionally, in the past, respite care services only involved placing the care recipients in the homes without arranging any activities. This caused the care recipients to feel bored and resentful, leading them to refuse to go again, and carers also felt uneasy about using the service.