Mixed Economy of Care or Nobody Care?A Critique of a Decade of Reforms in Long Term Care for the Elderly in Hong Kong

In view of the rising trend of population ageing, the Hong Kong Special Administrative Region Government had launched a series of reforms in long term care for the elderly since 2000. While based on the guiding principles of "ageing in place" and "continuum of care", the reforms were essentially built on the idea of mixed economy of care. Instead of relying on state provision alone, it was suggested that the care of the elderly could be delivered by a variety of sources, including families, neighbors, voluntary, non-governmental and private sectors.
These long term care reforms included an emphasis on community care, the support to family carers, the increase in reliance on private sectoras service providers, the establishment of gate-keeping mechanismfor targeting service recipients, the promotion of accreditation system for residential homes, the introduction of competitive bidding in the selection of subsidized service operators, and the exploration of means-testing and the use of voucher in long term care.
The purpose of this paper is to critically examine these long term care reforms in Hong Kong in the past decade from 2000 to 2010. A qualitative approach is adopted which include literature review of policy documents,statistics and service data and academic researches, as well as interviews of informants. It is hoped that the analysis can shed light on the development of long term care policies in other East Asian societies experiencing population ageing.