Fan Chuen-tat, 74, has expressed interest in moving to a care home in Guangdong, but worries about leaving his comfort zone. Photo: Elson Li

Living alone and relying on a cane to walk, 74-year-old Hongkonger Fan Chuen-tat plans to move into a care home as he grows older.

But he said he intended to leave the city and settle in a care facility in Guangdong province, drawn by the promise of bigger living spaces and lower costs across the border.

An expanded government scheme to subsidise care for elderly Hongkongers living in homes in the mainland Chinese province, as well as new incentives such as monthly allowances, have appealed to the former construction worker, who survives on Comprehensive Social Security Assistance payments of about HK$6,000 (US$773) a month.

“The mainland has bigger living spaces, unlike smaller, more expensive Hong Kong,” said Fan, who currently lives in a 200 sq ft (18.6 square metres) public housing flat in Yau Tong. He is divorced and has lost contact with his three adult sons, who have their own families.

Despite being willing to uproot, Fan said he still had concerns and remained hesitant.

“What will happen to us if we have emergencies and have to return to Hong Kong for treatment? What if the services across the border are not good? What if we cannot adapt to the new environment?” he said.

“It is, after all, a big decision to make.”

Fan said he was not alone. He said his worries were shared by a dozen of his elderly friends who had also shown interest in moving north.

Mainland facilities offering subsidised residential care for elderly Hongkongers have recorded low occupancy rates, despite the expansion of the city government’s scheme and a raft of new measures to support the move.

Figures submitted by the Labour and Welfare Bureau to the Legislative Council’s Finance Committee earlier this month showed that 316 elderly Hong Kong residents were living in 11 care homes under the Residential Care Services Scheme in Guangdong as of the end of last year.

Only 24 per cent of the 1,331 service places at the designated care homes o!ered to Hongkongers were occupied, according to the data.

The 11 facilities included two initial ones that had offered subsidised care for Hongkongers since 2014, and two that joined the scheme in May of last year. The remaining seven were added last November.

Another four care homes were added to the scheme in March this year.

The scheme is among the government’s initiatives to encourage elderly residents to move to the mainland and to provide them with more choices in the face of an ageing population.

Industry players and lawmakers have blamed the distance, limited medical support and lack of promotion for people’s hesitancy to uproot.

But operators expressed optimism and said the market needed time to grow.

Care homes under the scheme are now offering trial living packages, converting triple rooms into twin ones to create bigger living spaces, and renovating old facilities to attract more occupants.

Some are also looking to add more facilities in popular mainland cities.

“Hong Kong’s retirees are generally not very old, and the lower living cost on the mainland is a big attraction,” said Kenneth Chan Chi-yuk, chairman of Hong Kong-based Hygge Living, which operates two care facilities in Guangdong under the scheme.

In terms of locations, Shenzhen, Guangzhou and Foshan each have four centres involved in the scheme, while Zhaoqing, Zhongshan and Jiangmen have one each.

The Hong Kong Jockey Club Helping Hand Zhaoqing Home for the Elderly, one of the first two facilities under the scheme, is undergoing a large-scale renovation to boost its attraction.

Connie Chu Ho-nee, chief operating officer of Helping Hand, a Hong Kong charity that operates the facility, said the care home currently offered 228 service places, with about 50 Hongkongers and around 50 mainlanders living there.

She said the facility initially had 300 service places, and all of them were planned for housing Hongkongers, but its distance from the city had been a barrier.

Most of the Hongkongers at the centre were those originally from Zhaoqing or other nearby places, she added.

“There are more choices of facilities for residents under the expanded scheme, and after all, our care home is relatively far away from Hong Kong,” she said.

Chu said that the more than 20-year-old facility last year started having its rooms repainted and beds replaced as part of e!orts to attract more residents, with the renovations expected to be finished by the end of the year.

She added that the centre targeted residents from middle- and lower-income groups.。

Hygge Living chairman Chan said the Foshan Changxianghui Elderly Home, which is run by his company, offered 200 subsidised service places for residents from Hong Kong, with 90 of them already taken. The centre joined the scheme in May of last year.

About another 10 Hongkongers lived at the centre but were not receiving subsidised care, he said.

The average age of the residents was 83, and they included recipients of welfare allowances and retired professionals, he said.

Chan noted that about 10 people had left the care home in the past, including three who had died and one who needed hospitalisation in Hong Kong. The others had left for facilities in other cities under the expanded scheme, he said.

He said he was optimistic that the trend of older people moving across the border would grow, adding that the company would capitalise on it by providing an extra 200 rooms in a new building next to the current facility by around October.

Chan’s company also started operating another mainland facility, the Guangming Social Welfare Institute, under the scheme this year, with 377 service places on o!er. Seven Hongkongers and 61 mainlanders were currently living there, he said.

The Shenzhen facility converted previous triple rooms into double rooms to create bigger living spaces, which were popular among older couples from Hong Kong, Chan said.

He also said his company planned to add a third mainland care home this year.

The Hong Kong government’s measures to support the elderly relocating across the border include the launch of a cross-border ambulance transfer initiative last November.

The service enables patients in Shenzhen and Macau to be taken directly to public hospitals in Hong Kong.

It is also part of efforts to promote collaboration within the Greater Bay Area – Beijing’s initiative to turn Hong Kong, Macau and nine Guangdong cities into an economic powerhouse.

The Hong Kong government last year also increased the number of mainland institutions in the bay area accepting healthcare vouchers from older residents to pay for medical expenses from two to nine.

In his latest policy address last October, Chief Executive John Lee Ka-chiu said the government would share part of residents’ medical expenses under the Guangdong residential care scheme.

Lee also announced a new three-year pilot scheme to o!er a monthly subsidy of HK$5,000 to 1,000 elderly recipients of the Comprehensive Social Security Assistance if they chose to live in designated care homes in Guangdong, starting later this year.

Ivan Lin Wai-kiu, a community organiser of NGO the Society for Community Organisation, which serves the underprivileged, said about 40 older residents showed interest in moving into mainland care facilities after the announcement of the new incentives.

But many of them were still worried about the extra cost of calling ambulances to Hong Kong and hiring care workers in hospitals across the border, he said. Some hoped to move to care homes in mainland provinces other than Guangdong to be closer to their families.

He said some were also put o! by a lack of explanation of government policies, adding that even frontline social workers were not informed of relevant details to address residents’ concerns.

Lin said his organisation planned to take about 40 elderly residents on a day trip to visit two care facilities in Shenzhen free of charge next month. Retiree Fan is among those joining the trip.

Lawmaker Tik Chi-yuen, who represents the social welfare sector, said the new incentives would help, but obstacles such as residents’ worries about medical care and family visits, as well as a lack of information about the new measures, needed to be tackled.

He urged the government to step up the promotion of its various policies.

Care homes with low occupancy rates should also transform themselves to be more attractive to Hongkongers, he said.

“Authorities should review the facilities with long-term low occupancy rates under the scheme and allocate resources to those that are more favourable,” Tik said.

Chan, meanwhile, urged the government to o!er more medical support for those living across the border by providing online diagnosis and treatment, and entrusting Hong Kong-funded healthcare institutions on the mainland to o!er outreach services at care homes.

Despite the low occupancy rate of care homes, o"cial statistics showed an increase in the number of residents benefiting from the schemes that provided monthly allowances for elderly Hongkongers living in Guangdong and Fujian provinces.

According to data, there were 25,736 people under the Guangdong scheme as of the end of last year, up from 25,011 in the 2023-24 financial year and 22,034 in 2022-23.

There were 2,475 under the Fujian scheme as of the end of last year, up from 2,447 in 2023-24 and 2,116 in 2022-23.

Lawmaker Kingsley Wong Kwok, of the Hong Kong Federation of Trade Unions, said there was a trend of older residents moving to the mainland, including many who had bought homes there.

Wong suggested the government set up centres for the elderly in mainland cities to serve Hongkongers, and called on authorities to continue to review measures on how to better encourage older residents to move across the border.

“Barriers such as a lack of medical care need to be solved, which will lead to more older residents moving across the border,” he said.」