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Ageing society

Hong Kong’s elderly prisoner population has nearly doubled in past decade, and jails are struggling to cope

Escorting inmates for hospital treatment and to see medical specialists is a major drain on manpower, authorities say

PUBLISHED : Sunday, 24 June, 2018, 8:15am
UPDATED : Sunday, 24 June, 2018, 12:04pm

Hong Kong prisons are struggling to cope with an ageing population after the number of elderly inmates almost doubled in the past decade, placing tremendous pressure on manpower.

Figures obtained by the Post show the number of prisoners aged 60 and above surged by 86.8 per cent between 2007 and 2017, from 234 to 437. This came despite the overall prison population shrinking by 28.7 per cent, to reach 6,728.

Elderly prisoners accounted for 6.5 per cent of all inmates, compared with just 2.5 per cent in 2007.

Lawmakers and elderly care specialists urged the government to adopt age-friendly policies in prisons after the Correctional Services Department admitted health care needs had soared, piling pressure on guards and other staff.

One of the biggest drains on manpower is escorting prisoners to hospitals for treatment and to see specialists. The personnel deployed for medical escort duties significantly increased from about 39,000 man-days on average each year between 2014 and 2016 to 41,091 man-days in 2017, the department revealed.

A man-day is the amount of work performed by an average worker in one day.

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“Over the years, the numbers relating to medical escort duties have remained high, putting tremendous pressure on human resources and posing security risks,” a department spokeswoman said.

A veteran correctional officer stationed at Lai Chi Kok Reception Centre in Kowloon said more men aged 60 or above were being kept at the maximum security facility in recent years, and many had health issues.

“Some suffer from dementia. Some don’t even have the ability to care for themselves. They have problems eating, going to the toilet,” said the officer, on condition of anonymity. The source has more than 35 years of experience with the department.

“We also need to ask other prisoners to look after the sick ones ... help feed them and take them to the washroom.”

At least two officers were needed to escort severely sick inmates to hospital, he said.

Prisoners with less serious illnesses were kept in wards inside the prison, meaning many beds were occupied for long periods, he added.

Since 2015 some male prisoners have been given the chance to transfer to Evergreen Garden, a facility exclusively designed for seniors at Tai Lam Correctional Institution in the New Territories. But the inmates have to first pass a risk assessment as the facility has less stringent security. Once there, they are given low-intensity jobs, such as planting or binding books.

The department attributed the spike in demand for health care services to a rise in chronic diseases such as diabetes and hypertension, which were more common in the elderly as well as in those with substance abuse problems before entering prison.

It said a rehabilitation programme tailor-made for elderly inmates had been implemented but had failed to make up for additional medical costs.

Dr Lam Ching-choi, chairman of the government’s Elderly Commission, said the figures suggested it was time for prison authorities to do more to promote healthy ageing in light of the demographic changes.

But Lam cautioned that a single specialised institution like Evergreen Garden might not be a viable solution.

Instead, he said, prison authorities needed to change their management philosophy.

“There is huge room for the officers to promote healthy ageing among prisoners … such as by monitoring their health better, encouraging them to exercise more or providing more tailor-made health promotion programmes. These are neither very fancy nor special.”

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Lam, a paediatrician, argued the department could explore having medical specialists from the Hospital Authority provide on-site consultations to relieve pressure on medical escorts.

The ageing population is exactly an issue which the department has ignored in the past
Shiu Ka-chun, lawmaker

“As a person ages, he or she might at the same time suffer from several diseases and need to consult several doctors. An inmate might end up having check-ups [in hospitals] more than 10 times a year,” he said. “It is undeniable that society has been allocating a lot of resources.”

Another option would be adopting the idea of “telemedicine”, whereby doctors remotely diagnose patients using telecommunications technology. Lam believed this option would be easier to implement behind bars as doctors and nurses who work at a prison could help serve as a “specialist’s arm”.

Social welfare sector lawmaker Shiu Ka-chun, an advocate for prisoners’ rights, said the department needed to shed its old mindset and adopt more age-friendly policies.

“The department has always regarded inmates as monolithic,” Shiu said. “It only differentiates them by gender and ignores all other variables, such as their age or their special educational needs. The ageing population is exactly an issue which the department has ignored in the past.”

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Countries such as Britain and Singapore face similar challenges. The Singapore Prison Service retrofitted some prison cells a few years ago with senior-friendly features such as handrails, after its elderly inmate population doubled between 2012 and 2016.

Some researchers have also described the local situation as a “double punishment”, claiming the lack of facilities and programmes could create a harsher prison environment for older inmates.

Additional reporting by Christy Leung