Health Management and Social Care | An examination of the history and development of the social welfare system and its associated policies in Hong Kong, including study of its ideological and philosophical underpinnings.

Hong Kong's Social Welfare System: A Journey Through Time

Hey everyone! Welcome to your study notes for a fascinating part of HMSC. Ever wondered why we have services like CSSA or elderly centres in Hong Kong? And why are they run the way they are? This chapter is like being a detective, looking back at the history of Hong Kong's social welfare system. We'll uncover the big ideas that shaped it and see how it has changed over the years. Understanding this helps us understand the Hong Kong we live in today. Let's get started!

What is a Social Welfare System, Anyway?

Before we travel back in time, let's get our key term straight.

A social welfare system is a network of services and policies that a society puts in place to help its citizens meet their basic needs and improve their well-being. Think of it as a community's safety net, designed to catch people when they face difficulties like poverty, old age, disability, or unemployment.

Key Aims of a Social Welfare System:

• Providing financial assistance (e.g., money for food and rent).
• Offering support services (e.g., family counselling, childcare, elderly care).
• Protecting vulnerable groups (e.g., children, the elderly, people with disabilities).

Quick Review Box
Social Welfare System = A society's organised way of helping people. It's the "safety net" for citizens' well-being.

The 'Why': Ideological and Philosophical Underpinnings

This sounds complicated, but it's just about the core beliefs that shape the system. In Hong Kong, two big ideas have been very influential. Don't worry if this seems tricky at first, the analogy will make it super clear!

1. The Idea of 'Residualism'

This is the main philosophy behind Hong Kong's system. The word "residual" means "what's left over".

Residualism is the belief that welfare should be a last resort. Help is only provided when an individual's own resources and their family's support have failed. The government's role is minimal or "residual".

Analogy: Think of it like a fire extinguisher. You only use it in an emergency when you can't put out the fire yourself. It's not something you use every day. In the same way, residual welfare is for emergencies when family and personal savings (the market) can't help.

2. The Influence of 'Positive Non-interventionism'

For a long time, the Hong Kong government followed a policy of positive non-interventionism in the economy. This means "hands-off" – the government tried not to interfere with business, keeping taxes low to encourage economic growth. This economic idea spilled over into social policy.

• The government believed that a strong economy would create jobs and prosperity, which was the best form of welfare.
• They worried that providing too much welfare would lead to high taxes (bad for business) and make people lazy (the "welfare dependency" argument).

3. The Role of Confucian Values

Traditional Chinese culture, influenced by Confucianism, also plays a part. There is a strong emphasis on family responsibility and filial piety (respect and care for one's parents). This means society traditionally expects families, not the government, to be the first and main source of support for their members.

Key Takeaway
Hong Kong's social welfare system was built on the idea that welfare is a last-resort safety net (Residualism), not a universal right. This was influenced by a "hands-off" economic policy and the cultural belief in family as the primary caregiver.

A Walk Through History: Key Stages of Development

Let's see how these ideas played out in real life over the decades. We'll focus on the period from the 1970s onwards, as this is when the modern system really began to take shape.

Pre-1970s: The 'Do-Little' Era

Before the 70s, the government did very little. Most help for the poor came from charities, religious groups, and community organisations (NGOs). Welfare was not seen as a government responsibility.

The 1970s: The 'Big Change' Era

This decade was a massive turning point! Following the 1967 riots, the government, under Governor MacLehose, realised it needed to do more to address social problems to maintain stability.

• What happened? The government started introducing major social welfare schemes.
• Major Policies Introduced:
  • Public Assistance (PA) Scheme: This was the beginning of what we now call the Comprehensive Social Security Assistance (CSSA) scheme. It provided basic cash assistance to those who couldn't support themselves.
  • Disability Allowance (DA): Financial help for people with severe disabilities.
  • Old Age Allowance (OAA) or 'Fruit Money': A small monthly payment to the elderly to show respect.
• But remember... Even with these changes, the system was still firmly residual. You had to prove you were in genuine need (means-tested) to get most benefits.

Did you know? The Old Age Allowance is often called 'fruit money' (生果金) because the amount was originally intended to be just enough for an elderly person to buy some fruit and other small comforts.

The 1980s – 1990s: The 'Fine-Tuning' Era

Hong Kong's economy was booming! The government had more money, but it was still very cautious about expanding welfare too much.

• What happened? The focus was on improving and expanding existing services rather than creating brand new, universal ones.
• Direction of Development: More services were developed, especially for the elderly and people with disabilities. This included building more community centres, care homes, and support services, often run by NGOs but funded by the government.
• In 1993, the Public Assistance (PA) scheme was renamed CSSA, with payment rates increased to cover more than just bare essentials. This was a significant improvement, but the residual principle remained.

Post-1997 & 2000s: The 'New Challenges' Era

This period saw new problems that tested the welfare system.

• What happened? The Asian Financial Crisis (1997) led to unemployment and more people needing CSSA. At the same time, Hong Kong's population was rapidly ageing, putting more pressure on elderly services.
• Direction of Development: The government became very concerned about the rising cost of welfare.
  • There was a greater emphasis on "self-reliance" and getting people off CSSA and back into the workforce.
  • A shift towards community-based care for the elderly, trying to help them live at home for as long as possible instead of in expensive residential homes.

Key Takeaway
The system grew from almost nothing before the 1970s to a structured system of financial aid and support services. It developed in response to social crises (like the riots) and new challenges (like an ageing population), but the core philosophy of being a 'last resort' has largely remained the same.

Analysing the Changes in the Welfare System

So, what are the big-picture changes we can see over time?

1. Priority in Government Policy

Welfare has moved from being a very low priority (pre-1970s) to a significant area of government spending and policy. However, it is often still seen as secondary to economic development.

2. Direction of Development

The system has moved from providing just basic cash handouts to offering a much wider and more complex range of support services. There is now more focus on rehabilitation, community support, and empowering individuals.

Example: Instead of just giving an unemployed person money, the system now also provides job retraining and counselling.

3. Areas of Services

The scope of services has expanded from helping only the most destitute to addressing the needs of specific vulnerable groups, such as the elderly, people with disabilities, single-parent families, and new arrivals.

Common Mistake to Avoid!
When analysing the system, don't just say "it got bigger". Be specific! Talk about *how* it changed in terms of priority, direction, and scope of services. Use examples like the creation of CSSA or the shift to community-based care.

Strengths and Shortcomings of the Current Policies

For your DSE, you need a balanced view. Let's look at the good and the not-so-good.

Strengths (The Good Parts)

• Provides a Basic Safety Net: The system, especially CSSA, does prevent extreme poverty and ensures people have a minimum standard of living.
• Well-Targeted: Because it's "means-tested" (you have to prove you have low income/assets), it directs limited resources to those who are proven to be most in need.
• Diverse Services through NGOs: The government partners with many non-governmental organisations (NGOs), which allows for a wide variety of specialised services (e.g., specific services for autistic children, or for ethnic minorities).

Shortcomings (The Areas for Improvement)

• The Stigma Problem: Receiving welfare, especially CSSA, is often seen as shameful in society. This can stop people who genuinely need help from applying for it.
• Stringent Eligibility: The means-tests can be very strict. Some people who are struggling (the "working poor") might earn just enough to be disqualified from receiving help.
• Potential for Dependency: Critics argue that the system can sometimes create a "welfare trap" where it is difficult for people to get back into the workforce, though this is a heavily debated point.
• Reactive, Not Proactive: The system is often criticised for being reactive – it helps people *after* they fall into crisis, rather than being proactive and preventing the problems from happening in the first place.
• Adequacy of Support: There is an ongoing debate about whether the financial assistance provided is truly enough to live a dignified life in a high-cost city like Hong Kong.

Key Takeaway
Hong Kong's social welfare system is a balancing act. It successfully provides a crucial safety net for the most vulnerable (its main strength), but it faces challenges related to social stigma, strict rules, and questions about whether it does enough to prevent poverty (its main shortcomings).