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HongKongEcho: Retire in the GBA? Aged care homes just across the border look to woo Hong Kong’s elderly

The Greater Bay Area promises a lot. Affordable nursing homes for Hong Kong’s elderly is the latest ambition to ease the city’s care crisis.

As 100-year-olds go, Hui Yat Fung is spritelier than most. A little hard of hearing, certainly, but she’s quick to confirm to us her status as the most senior resident at the Tsang Shiu Tim Home for the elderly with an energetic chatter that belies her years.

She’s among 113 living at the private facility in the upmarket southern Hong Kong district of Pok Fu Lam. Operated by the Hong Kong Society for Rehabilitation, a non-government organisation (NGO), it’s on the upper end of what Hong Kong has to offer with beds there priced from HK$17,350 to HK$45,600 in rooms of four or less.

Fresh air and gardening are among the attractions for aged care homes in Guangdong

In that sense Hui is one of the lucky ones. Those unable to snag a place in a residence like this may sit on waiting list for a government subvented home for up to three-and-a-half years.

But for a fraction of the price, and without the queue, the NGO’s sister facility in Shenzhen is luring an increasing number of Hong Kong’s elderly to live out their later years across the border.

Moving to the mainland

“We’ve seen a definite uptick in interest from Hong Kong residents in our mainland facility in the last few years,” says Pamela Leung, CEO of the Hong Kong Society for Rehabilitation.

Nestled in a quiet hill overlooking the eastern Yantian District of Shenzhen, the home known as Yee Hong Heights was first established in 2006 as an affordable yet quality alternative for Hong Kong’s elderly.

Monthly fees start at HK$3,210 for the most basic packages, with government-subsidised places also available. Today it’s home to 321 residents – a little over 60% of them are from Hong Kong and the rest hail from the mainland. Leung expects that to rise closer to 70% in coming years, while it continues to be fully staffed by mainland workers.

Interest from Hong Kong residents has grown according to Pamela Leung, CEO of the Hong Kong Society for Rehabilitation

An estimated 77,000 elderly Hong Kongese (aged 65 and over) already reside in Guangdong, although Yee Hong Heights is just one of two homes offering subsidised places for Hong Kong citizens.

“Typically, the elderly come here for the space, fresh air, and a much more reasonable cost of living,” explains Leung. Horticulture, plentiful space for exercise, and even an in-house hair salon are among the features that set it apart. So too an average 37 square metres space per person, a generous improvement on the 6.5 square metre average mandated in Hong Kong.

Not all smooth sailing

“Increased transport links and job opportunities in the Greater Bay Area will make retiring in the mainland increasingly attractive,” says Colman Wong, CEO of Helping Hand, the only other Hong Kong NGO operating in the region. Its 270-bed facility in Zhaoqing – a prefecture 100 kilometres to the west of Guangzhou – opened in 2001.

Like Yee Hong Heights, it holds accreditation from the Hong Kong Association of Gerontology and is similarly able to employ in-house doctors due to lower operating costs. For its Hong Kong clients, it primarily offers government-subvented places with a strong focus on dementia treatment.

Wong was part of the team that spearheaded the project’s creation and remembers embarking with the first batch of Hong Kongese to take the trip. “There were only nine of us!” he remarks. That peaked in following years to just over 60, with only a handful of mainland residents. Today, the balance has shifted to roughly 90-20 in favour of elderly from the mainland.

“It’s not just about money – manpower planning is essential,” says Colman Wong, CEO of Helping Hand

He attributes the shift to an incomplete subsidy policy for elderly Hong Kongese in Guangdong as well as a reluctance among some to move to the mainland in the mid-2000s.

It’s worth noting, likewise, that since the introduction of a Pilot Residential Care Services Scheme in Guangdong in 2014, only an estimated 180 elderly have taken up the offer of 400 places in facilities in mainland China to skip waiting lines in Hong Kong for government subvented beds.

Facilities at Yee Hong Heights offer 37 sqm of space per person compared to 6.5 sqm in Hong Kong

While Wong admits 2018 saw inquiries from Hong Kong clients trickle out to almost nothing, the second half of 2019 has seen renewed interest in the facility.

Increased coverage of Hong Kong’s subsidies for the elderly, due to come into effect in January 2020, is cause for optimism according to Wong. Still, reducing Hong Kong’s 40,000-strong waiting list for public and private homes will require a more nuanced approach if the Greater Bay Area is to bolster the sector in a meaningful way.

“It’s not just about money – manpower planning is essential,” says Wong. A shortage of social workers and elderly care programme experts in the mainland is one hurdle for rolling out more homes.

Many Hong Kong-based NGOs may also be reluctant to enter the space as receiving full tax exemption requires registering the company with unlimited liability – a step groups like Helping Hand have not been prepared to take. “But because of the enormous opportunities in China’s senior care market, you will see more profit-making companies take that risk,” says Wong.

International players, too, are eying the space. French elderly care giant ORPEA opened China’s first fully foreign-backed elderly care home in Nanjing in 2016. “The elderly care industry is only just starting to develop in China,” says the group’s China CEO, Nathaniel Farouz. “We’ve actually been repeatedly solicited by various Chinese government bodies to help bring and adapt our know-how in order to contribute to this development.”

While ORPEA has no current plans to expand operations to the Greater Bay Area, its engagement in the market signals the kind of development seasoned operators like Leung predicts will shape the region. “We’ll start to see more options for Hong Kong’s elderly in the Greater Bay Area as more enterprises enter the space with a quality offering.”