Appendix III
Environmental Scan
Background
To facilitate the review of the Hong Kong Rehabilitation Programme
Plan (RPP), the Working Group responsible for the review has taken stock of the
number of rehabilitation service users and examined the factors affecting the
service development. A summary of the data/factors examined by the Working
Group is set out in this annex.
Summary
(a)
Number and Prevalence Rate of Service Users
2.
A territory-wide survey on persons with disabilities and chronic diseases
was conducted by the Census and Statistic Department (C&SD) throughout the
entire year of 2000 to gauge the total number and prevalence rate of persons
with selected types of disability and chronic diseases. The data from this
survey have been published in the Special Topics Report No. 28 on Persons with
Disabilities and Chronic Diseases.
3.
At the time of enumeration, it was estimated that there were 269 500
persons with disabilities. The overall prevalence rate of persons with disabilities
was 4 %. For the number of persons with individual types of disability, please
refer to Table 1. The survey also estimated that the total number of mentally
handicapped persons in Hong Kong was about 62 000 to 87 000, representing a
prevalence rate of some 0.9% to 1.3%.
1
Table 1:
Number and Prevalence Rate of Service Users
Types of Disability
Number of
Persons
Restriction in body movement
As % of
the total population of
Hong Kong
103 500
1.5
Seeing difficulty
73 900
1.1
Hearing difficulty
69 700
1.0
Mental illness
50 500
0.7
Speech difficulty
18 500
0.3
Autism
3 000
Total:
<0.05
269 500
4.0
Note:
(1)
Classification and definitions of disabilities adopted by the Special Topics Report No. 28 on
Persons with Disabilities and Chronic Diseases are as follows:

“Persons with restriction in body movement” were defined as those who had been
diagnosed as being physically handicapped under medical assessment tests (such as
spasm, paraplegia and quadriplegia, and loss of limbs) or perceived themselves as
having long-term difficulty in movement of upper/lower limb or other parts of the
body;

“Persons with seeing difficulty” referred to those who had been diagnosed as being
blind or having low vision under medical assessment tests or perceived themselves as
having long-term difficulty in seeing with one eye or both eyes whether with or
without
correcting
glasses/contact
lenses.
Nevertheless,
nearsightedness,
farsightedness, astigmatism and presbyopia were excluded;

“Persons with hearing difficulty” were defined as those who had been diagnosed as
having hearing impairment under medical assessment tests or perceived themselves as
having long-term difficulty in hearing. Based on the information collected in the
survey, they were classified into three categories: (i) unable to hear at all; (ii) required
a specialised hearing aid in order to be able to hear well; and (iii) not required a
specialised hearing aid;

“Persons with speech difficulty” referred to those who had been diagnosed as having
2
speech impairment under medical assessment tests or perceived themselves as having
long-term difficulty in speaking and being understood by others. They were classified
into three categories in the survey: (i) unable to speak at all; (ii) required a specialised
aid in order to be able to speak and be understood by others; and (iii) not required a
specialised aid;

“Mentally ill persons” were defined as those who had been diagnosed as being
mentally ill under medical assessment tests (including ex-mentally ill) or had
been/were being treated by psychiatrists or had received/were receiving some form of
rehabilitation services provided for ex-mentally ill persons (such as psychiatric clinics,
private psychiatrists, halfway houses and community psychiatric nursing services) at
the time of enumeration;

“Autistic persons” referred to those who had been diagnosed as being autistic under
medical assessment tests; and

“Mentally handicapped persons” referred to those who had been diagnosed as being
mentally handicapped (or with intellectual disabilities) under medical assessment tests.
Down's syndrome was included.
(2)
A service user may have more than one type of disability and hence the overall number of
persons with disabilities is smaller than the sum of the number of persons with individual
types of disability.
(3)
The survey also collected information on persons with intellectual disabilities residing in
institutions and in domestic households.
However, there was strong indication of
under-estimation in respect of the number of persons with intellectual disabilities in domestic
households as derived from the survey findings. Hence, the analysis of survey findings
pertaining to the persons with intellectual disabilities has been separated from that of persons
with other types of disability in this report. A crude statistical assessment indicated that the
total number of persons with intellectual disabilities in Hong Kong was likely to be in the
region of 62 000 – 87 000, representing a prevalence rate of some 0.9%-1.3% for persons
with intellectual disabilities in Hong Kong.
(4)
Statistical data on persons with visceral disability in Hong Kong is not available for the time
being. However, the survey estimated that there were some 882 700 persons reporting their
requirement for long-term (i.e. lasting at least six months) medical treatment, consultation or
medication (referred to as “persons with chronic diseases”). The prevalence rate of persons
with chronic diseases was 13.0%. Among these 882 700 persons, 731 600 indicated that
3
they did not have any selected type of disability as shown in Table 1.
(5)
The C&SD will conduct another survey in 2007/08 with a view to updating the related
figures and information.
(b)
Social Factors Affecting the Number of Service Users
(i)
Elderly Population
4.
Hong Kong has the lowest birth rate among the 225 countries and places
in the world, with only 7.63 new births per 1 000 population. The fertility rate
is only 0.91 birth per woman. This, coupled with the increase in average life
expectancy, means that the ageing of our population will become more
pronounced. According to the Hong Kong Population Projections 2004-2033
published by the C&SD in 2004, it is estimated that people aged 65 and above
will account for 26.8% of the territory’s total population by 2033, representing a
remarkable growth as compared with 7% in 1983 (Table 2). It is also estimated
that the number of service users with mobility difficulty, visual impairment and
hearing impairment will be on the rise as such disabilities are common to the
aged.
Table 2:
Elderly Population
population
percentage
26.8%
2 500 000
30%
2 243 100
2 000 000
25%
19.4%
1 548 500
20%
1 500 000
13.2%
978 000
11.7%
1 000 000
9.3%
7.0%
500 000
15%
795 500
10%
546 000
374 600
5%
0
year
0%
1983
1993
2003
2013
no. of elderly aged over 65
4
2023
2033
as percentage of the total population
(ii)
Median Age at First Childbirth
5.
Infants with congenital defects are often born to older mothers.
According to the findings of a survey conducted by the C&SD in 2004, there
was a rising trend in the median age of Hong Kong women at first childbirth
(Table 3), from the age of 26.2 in 1985 to 29.4 in 2004. Nevertheless, with the
increasing popularity of premarital/antenatal check-ups, the rising trend in the
median age of these mothers does not necessarily translate into a higher birth
rate of infants with congenital defects.
Table 3:
Number of Births and the Median Age at First Childbirth
no. of births
80000
age
76126
30
67731
70000
68637
28.7
60000
29.3
29
54134
47892
27.8
50000
29.4
40000
30000
28
27
26.2
26
20000
25
10000
0
year
24
1985
1990
no. of births
(iii)
1995
2000
2004
median age at first childbirth
Number of Cases Receiving Child Assessment Service (for Children
Aged 0-11) and Student Health Service (for Students from Primary 1
to Form 7) from the Department of Health
6.
With the enhancement of child assessment service and student health
service under the Department of Health (DH), the continuous improvement in
impairment/disease detection and prevention technologies, as well as the
increased awareness of the importance of early intervention among parents,
there is a general rising trend in the number of cases receiving child assessment
service and student health service from the DH (Table 4). This will facilitate
5
early prevention and intervention, thereby preventing the development of
impairments/diseases into disabilities and helping to reduce the prevalence rate
of rehabilitation service users.
Table 4:
Total Number of Cases Receiving Child Assessment Service (for Children
Aged 0-11) and Student Health Service (for Students from Primary 1 to Form
7) from the Department of Health
no. of cases
2500
2212
2000
1650
in 2000
1500
in 2005
1089
897
1000
500
490
352
1007
870
473
218
405
217
145
178
4681
0
it
fic
de
di
y
li t
t
m
r/e
l ty
de
cu
ffi
r
so
en
m
di
t
en
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ir
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io
nt
im
al
ir
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in
rn
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y
li t
en
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ic
ys
te
at
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in
ec
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ir
pa
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ch
ee
ll
te
sp
in
na
io
ot
la
nd
ha
be
r
ou
vi
al
lem
ob
pr
s
(iv)
Number of Injuries Caused by Occupational, Industrial and Traffic
Accidents
7.
With the sustained improvement in the occupational, industrial and
traffic safety legislation and measures, a downward trend in the number of injury
cases caused by occupational, industrial and traffic accidents is detected as
shown in Tables 5 to 8. This will help reduce the number of adults using
rehabilitation service.
6
Table 5:
Number of Occupational Injury Cases
non-fatal cases
fatal cases
70000
300
60000
250
50000
200
40000
150
30000
100
20000
50
10000
0
year
0
1998
1999
2000
2001
2002
non-fatal cases
Table 6:
2003
2004
2005
fatal cases
Number of Industrial Accidents
accident rate per
1 000 workers
no. of accidents
50000
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
year
70
60
50
40
30
20
10
0
1998
1999
2000
2001
2002
non-fatal cases
2003
2004
2005
accident rate per 1 000 workers
7
Table 7:
Number of Cases Assessed as Permanent Loss of Earning Capacity under the
Employees’ Compensation Ordinance
no.of cases
20000
18000
16000
14000
12000
10000
8000
6000
4000
2000
0
year
Table 8:
1998
1999
2000
2001
2002
2003
2004
2005
Number of Injuries/Deaths Caused by Traffic Accidents
no. of severely injured
no.of deaths
4000
250
3500
200
3000
2500
150
2000
100
1500
1000
50
500
0
year
0
1998
1999
2000
2001
2002
severely injured
8
2003
deaths
2004
2005
(v)
Mental Health Problem
8.
Tables 9 to 11 show an increase in the number of psychiatric inpatient,
outpatient and day attendances at hospitals under the Hospital Authority in
2005/06 as compared with 2001/02, and in particular, there is a marked rising
trend in the number of young service users aged below 18.
Table 9:
Number of Discharges and Deaths of Psychiatric Inpatients and Day Patients
of the Hospital Authority
no.
ofpatients
patients
no. of
18000
16000
14000
12000
aged 65 or
above
10000
aged 18-64
8000
aged below 18
6000
4000
2000
0
financial year
2001/02
2002/03
2003/04
2004/05
2005/06
aged 65 or above
1793
1822
1606
1837
1800
aged 18-64
11317
11531
11240
12212
12577
438
579
691
987
954
aged below 18
Note: Age refers to mid-year age
Patients whose ages are not identified are not included in the above data
9
Table 10: Number of Psychiatric Outpatient Attendances at Hospitals under the
Hospital Authority
no. of attendance
700000
600000
aged 65 or
above
500000
400000
aged 18-64
300000
aged below 18
200000
100000
0
2001/02
2002/03
2003/04
2004/05
2005/06
aged 65 or above
100011
109229
102683
108659
115693
aged 18-64
389051
414824
415284
440725
460746
aged below 18
22039
25060
25456
27363
29496
financial year
Note: Age refers to mid-year age
Patients whose ages are not identified are not included in the above data
Table 11: Number of Psychiatric Day Attendances at Hospitals under the Hospital
Authority
no. of attendance
200000
180000
160000
140000
aged 65 or
above
120000
100000
aged 18-64
80000
60000
aged below 18
40000
20000
0
2001/02
2002/03
2003/04
2004/05
2005/06
aged 65 or above
18853
28093
20425
25544
27236
aged 18-64
151041
137716
116689
128693
136338
aged below 18
10870
17520
17515
18986
19913
Note: Age refers to mid-year age
10
financial year
(c)
Education Services
9.
The Working Group has also taken stock of the numbers of students
with disabilities enrolled in special and ordinary schools respectively as well as
the number of students referred from ordinary schools to special schools in the
past few years. The number of students in special schools, the number of
students with disabilities in ordinary schools, as well as the number of students
referred from ordinary schools to special schools from 2001 to 2005 are shown
in Tables 12, 13 and 14 respectively.
Table 12: Number of Students in Special Schools
2001/02
2002/03
5107
5178
Visual Impairment
164
Hearing Impairment
Physical Disability
Intellectual Disability
Total
2003/04
2004/05
2005/06
5235
5111
5135
154
164
160
157
427
394
362
332
292
732
754
762
778
796
6430
6480
6523
6381
6380
Table 13: Number of Students with Disabilities in Ordinary Schools*
2001/02
2002/03 2003/04 2004/05
2005/06
Intellectual Disability
619
722
926
1012
974
Hearing Impairment
715
783
872
902
932
Visual Impairment
110
64
55
69
117
Physical Disability
220
209
200
214
205
Autism
202
318
509
601
662
#
1109
1159
1133
1356
1866
3205
3721
3931
4246
Speech Impairment
Total
Note:
* In September 2006, the numbers of students with specific learning difficulties and attention
deficit/hyperactivity disorder were 5 960 and 431 respectively.
# data not available
11
Table 14: Number of Students Referred by Ordinary Schools to Special Schools
2001/02
2002/03
2003/04
2004/05
2005/06
95
97
129
11 9
123
Visual Impairment
1
1
1
7
0
Hearing Impairment
8
1
4
1
0
Physical Disability
15
9
13
12
13
11 9
108
147
139
136
Intellectual Disability
Total
(d)
Vocational Training and Rehabilitation
10.
The Working Group has also reviewed the vocational training and
rehabilitation service provided by the Labour Department (LD), Vocational
Training Council (VTC) and Social Welfare Department (SWD). Table 15
shows that the number of people who successfully secured employment with the
assistance of the LD’s Selective Placement Division increased from 2 007 in
2000 to 2 459 in 2005. Among those who successfully secured employment,
most of them are persons with intellectual disabilities and hearing impairment,
while the employment level for those with visual impairment has persistently
been on the low end.
Table 15: Number of People Securing Job Placement with the Assistance of the Selective
Placement Division of the Labour Department
no. of people
3000
no. of hearing
imparied persons
2 572
2 348
2 442
2 391
2 459
no. of visually
impaired persons
2500
2 007
648
1500
58
271
1000
500
663
540
652
794
72
203
64
199
293
277
426
428
864
745
697
2003
2004
2005
646
2000
90
319
357
229
350
57
262
87
208
356
352
477
391
757
2002
356
451
580
2000
2001
0
year
口
12
no. of persons
with physical
disabilities
no. of persons
with chonic
diseases
no. of persons
with psychiatric
disabilities
no. of persons
with intellectual
disabilities
11.
Table 16 shows the employment situation of graduates from the VTC’s
skills centres. The number of graduates pursuing full-time education is on a
downward trend while the number of those seeking employment is on a rising
trend.
Table 16: Employment Situation of Graduates from Skills Centres
no. of people
450
390
400
no. of graduates
in employment
366
325
340
350
309
417
300
219
222
250
213
216
194
200
100
50
0
year
38
7
40
37
7
47
41
7
66
6
no. of graduates
waiting to report
for duty
no. of graduates
pursuing full-time
education
165
150
no. of graduates
seeking
employment
54
55
56
40
3
12
3
19
24
36
41
43
32
39
2000
2001
2002
2003
2004
2005
no. of graduates
not seeking
employment
12.
Regarding its vocational rehabilitation services, the SWD has initiated
the process of reengineering some of its resources for sheltered workshops (SW)
and supported employment (SE) since 2005 to provide one-stop vocational
rehabilitation and training for PWDs through integrated vocational rehabilitation
services (IVRS). Overall speaking, as shown in Table 17, the number of places
for the SWD’s vocational rehabilitation services, including SW, SE and IVRS
centres, has increased from 8 275 in 2001 to 9 647 in 2005.
13.
Tables 18 and 19 show a rising trend in the number of people waitlisted
for SW and the waiting time involved. The number of people waitlisted for SE
generally remains below 250, whereas the average waiting time is less than 2.5
months.
13
Table 17: Vocational Rehabilitation Services of the Social Welfare Department
no. of places
12,000
8,000
integrated vocational
rehabilitation
services centre
(IVRSC)
6,000
supported
employment (SE)
10,000
4,000
sheltered workshop
(SW)
2,000
0
year
2001
2002
2003
2004
2005
口
Table 18: Waiting Time and Number of People Waitlisted for Sheltered Workshop (SW)
no. of people
time (month)
2500
14
12
2000
10
1500
8
1000
6
4
500
0
year
2
0
2001
2002
2003
2004
2005
口
no. of people waitlisted for SW
average waiting time (month)
14
Table 19: Waiting Time and Number of People Waitlisted for Supported Employment
(SE)
no. of people
time (month)
300
3
250
2.5
200
2
150
1.5
100
1
50
0.5
0
year
口
0
2001
2002
2003
no. of people waitlisted for SE
- END -
15
2004
2005
average waiting time (month)