Young At Heart

Perhaps because this is the month I became eligible for Hong Kong’s "fruit money" (payable on a non-means-tested basis at age 70), I have been taking a closer look at the issue of aging. The picture doesn’t look good, and I don’t just mean the wrinkles and increasingly stubborn paunch.

The numbers are frightening and our minister for Labour and Welfare, Dr Law Chi-kwong, has spoken of an aging tsunami. For once, use of such a striking expression is not hyperbole.

Let’s get some numbers on the table. Hong Kong people now enjoy the longest life expectancy in the world at over 84 (87 for women, 81 for men). Remember these are averages, so many will live much longer. That sounds like good news, and indeed it is. But because of our low birth rate, the demographics of our city are changing: we are aging fast. By one estimate, by mid-century more than one third of the population (excluding Foreign Domestic Helpers) could be over 65 which has been for some time our definition of when old age begins. That is why Old Age Allowance on a means-tested basis begins at that point.

But as fast as the number of seniors is rising, because of the low fertility the size of our workforce is levelling off, forecast to peak at 3.6 million in just two years’ time. By mid-century we could have a workforce of only 3.2 million supporting an army of 2.6 million over 65s.

Slightly better news is that improving general health means most of us can now expect to be active and reasonably fit into our 70s. That is where the overall fitness situation starts to change. During their 70s and early 80s, the majority start to become more frail and fragile. By 85, only a minority can expect a full independent life without a degree of support. If we want to help those who cannot survive without it, then we must boost the productive capacity of the remainder.

These are the facts, so what lessons should we learn from them? The first obvious one is that all reference to 65 as representing the normal retirement age should be abandoned. The administration needs to take the lead here rather than drift along passively behind changing circumstances. When I joined the government in 1980, the normal retirement age was 55, and it was possible to opt out fairly easily at 50, and with justification at 45. How absurd those numbers seem now. With the passage of time, an option was introduced to extend to age 60, and new recruits are now expected to soldier on to 65. But why are we kicking people out at that age if they still have the ability to make a constructive contribution?

It is time for more creative thinking. Staff do not need to progress in linear fashion right up to decrepitude: they can step aside into new less physically demanding lines of work in the same field. If my house is on fire I want you to send me a firemen in his 20s or 30s to carry me to safety. But someone in his 60s or even – if alert – older could just as well check building plans for means of escape, or inspect premises to ensure staircases are not blocked. There are other ways to carve up the workload too. Former Secretary for Lands and Works Chan Nai-keung once suggested to me that engineers and architects should only be allowed to design and build new projects up to the age of 50, thereafter they should be made responsible for maintenance. That would ensure all new bridges, tunnels and buildings were easy to maintain, and experienced professionals could still make a contribution to society.

Nor do we need to stop there. We must urgently get much more serious about re-training. With the fast-changing work environment, those leaving school now must be prepared to have four or five different careers during their working lifetime.

There can still be a role for unskilled older workers too, perhaps in less glamourous jobs. I for one would have no objection to senior citizens sorting refuse provided it was part of a systematic public recycling programme and they were properly remunerated. What grates is the sight of "cardboard grannies" scavenging because they have to do so to make ends meet.

Based on the current demand for subsidised nursing homes, there is a current shortfall of 300 (each of 100 places) and demand for a further 1,200 over the next 40 years. The good thing about these numbers is that they are so crazy – there isn’t the land, the money, or the trained staff – that we need to consider radically different options. The vast majority of seniors in any event prefer to "age in place", which means in their own home. So how can we achieve that situation, and defer for as long as possible the need for intensive long term care in institutions?

Family support will be essential, of course, but as time passes this will need to be buttressed by hired care which can be call-in or live-in according to individual circumstances. Local hires can take some of the burden, particularly if there is no live-in requirement, but in the latter case we can only realistically look to imported labour, perhaps with support from a more comprehensive district nurse outreach scheme. The numbers are staggering – probably demand for an additional 200,000 plus on top of the 380,000 FDHs already working here. Have we plumbed the well of the Philippines and Indonesia to its maximum? Is it time, perhaps, to reconsider our longstanding policy to bar mainlanders from the scheme? I rather think it is.