25 Nov 2009

Members' Motions 'Support for people with mental illness and people recovering from mental illness’

President, today, we are having a debate on Dr PAN Pey-chyou's motion and the amendments put forward by other Members. I notice that there are some reports in the morning papers today on the creation of the Case Manager Grade by the Hospital Authority (HA). It is reported that the grade will be created in the three districts with greater numbers of mental patients. After a trial of one year, a review will be conducted, and if the result is satisfactory, the new case management practice will be extended to the whole of Hong Kong three years later. The HA's pilot scheme can be described as belated support, but it has still taken a right step anyway.

Several meetings were held by the Legislative Council Panel on Welfare Services to discuss the support for mental patients and ex-mental patients. It even held a joint meeting with the Panel on Welfare Services, during which relevant organizations were invited to send deputations to offer their views. At the joint meeting, many deputations put forward their precious advice and constructive recommendations, including the creation of the Case Manager Grade I have just referred to. I understand that the Government did reply to the advice and recommendations of the deputations, but it is a pity that some of its replies failed to address the core issues and offer appropriate community support for mental patients and ex-mental patients.

In regard to resources, for example, some deputations pointed out that Hong Kong's public expenditure on mental health services only accounted for 0.2% of its Gross Domestic Product (GDP), lagging far behind the 1% in other developed countries. Admittedly, the annual government expenditure on mental health services amounts to a total of $3.2 billion, and last year, the Government also allocated an additional funding of $250 million to the HA and another $86.3 million to the Social Welfare Department (SWD). However, the SWD spent only several dozen million dollars on the provision of community support, which was seriously divorced from the actual needs.

Some other deputations also pointed out the acute shortage of psychiatric services of the HA, as mentioned by some Members just now. They said that there were more than 150 000 mental patients in Hong Kong, but there were only 300 psychiatrists, meaning that one psychiatrist must deal with 300 patients. As a result, they said, a psychiatrist could only have very limited time for getting to know the condition of his patients and carrying out diagnoses. Additional resources have since been allocated, but relative to the number of patients, such increased resources are just a drop in the bucket.

President, there are only 197 psychiatric social workers in Hong Kong. Each social worker is allocated roughly 78 cases for handling, with the result that only 15 000 cases can be handled at any one time. This is just 10% of the 150 000 mental illness cases. How can such a level of manpower cope with the heavy workload? And, we must not forget that the demand may keep increasing.

The Government claims that the HA has recruited more psychiatrists in recent years to strengthen the support for the provision of mental health services. But having read the latest annual report of the HA, I cannot see any substantial government funding for the training and recruitment of psychiatric health care professionals, rehabilitation personnel and paramedics, such as doctors, social workers, nurses, occupational therapists, clinical psychologists and physiotherapists.

Unless the HA can disclose the relevant information through other easily accessible and transparent channels, I will think that Dr LEUNG Ka-lau's amendment, which criticizes the present funding mechanism for lacking in any transparency, is well justified. As for Dr LEUNG's suggestion on establishing an independent funding mechanism similar to those in other countries, I am of the view that the Government should first conduct some studies and consult the stakeholders before deciding whether the proposal is appropriate and feasible. It should not turn down the proposal at this stage before conducting any studies.

President, I so submit.