Migrant domestic workers can contribute more than we expect
Firstly, local NGO Enrich HK, working with Experian, launched their landmark report on the economic contributions of migrant domestic workers (MDWs) to Hong Kong’s economy. The report calculated the real value of MDWs’ work in Hong Kong by taking the amount of time spent on various different tasks, then multiplying it by the local market value and then multiplying that figure by 385,000 — the total number of MDWs in the SAR. The final number was quite remarkable — HK$71.2 billion. Given how the majority of the work done by MDWs is “unseen”, the contribution is even more remarkable.
Secondly, across town, Dr Lam Chingchoi, chairman of the Elderly Commission, took to the air waves to deny media reports that MDWs would become core workers in the government’s elder care institutions which were due to be expanded after the recent budget announcement. These rumors came about because of the pilot scheme of the Social Welfare Department to train 300 MDWs on how to care for frail elderly people, free of charge. In this case, it was a case of two-plus-two equalling five.
Dr Lam was quite right to state that MDWs could not be relied upon as a key manpower resource for government elder care institutions for two reasons — most are not trained properly to adequately manage long-term, chronic care needs; and, secondly, the current legal and immigration framework would simply not permit them to undertake such work.
However, this is not to say that this should be the case in perpetuity.
The experience from almost every other advanced economy is that the care sector, and the elderly care sector, in particular, always struggles with manpower. While hugely rewarding, the work is often poorly paid and not highly regarded and appreciated by society. This experience tells us that as institutional care expands in Hong Kong, which it inevitably will, there will be a need to think in an innovative way to derive the necessary manpower. Again, in common with many other places, migration will likely be a key, if not a primary, source of manpower.
But, of course, the role of caregivers in institutions will only ever represent a small proportion of the care economy in Hong Kong. All would admit that it’s better for the elderly to “age in place”, to remain at home for as long as possible. This is better for the health and well-being of the individual and, of course, better for the public purse. However, in order to ensure that people are able to stay out of institutions for as long as possible, they must be able to access the appropriate levels of care.
The Social Welfare Department’s pilot program is a very welcome first step in offering the requisite skills training to MDWs to allow them to be central to this concept of “ageing in place”. As complex, chronic care needs develop, and as the demand for such services increases over time, it’s crucial that the training is expanded in both coverage and scope. The professionalization of the care sector, starting with MDWs, represents a win-win for all. The upskilling of MDWs will not only allow them to offer better care, but will also give them the opportunity to develop their own businesses upon leaving Hong Kong (which could, in turn, develop a snowball effect of the development of skills training in their home countries). Better skills can also translate into better salaries which, combined with financial literacy and inclusion projects, would lead to better lives for women and their families across the region.
It may also be time to revisit (once more) the immigration framework for MDWs, and to explore the extent to which care can be “shared” between families. This is a rational response to varying degrees of need. For some individuals and families, an hour’s support per day could make all the difference, while for others, roundthe-clock intensive care is required. Yet, both these two extreme types of citizens would be subject to the same requirement of an MDW living-in and having only one employer, and probably pay the same salary as well. Developing a more flexible framework, which enhances accountability for both employers and employees, is surely a priority. The current system is designed around the relatively homogeneous care needs of children in terms of time and skill level. As we transition toward a model where care is more directed toward our older population, which has much more heterogeneous care needs, we surely need to examine whether our current immigration system is fit for this purpose.
This then returns us to the contribution of MDWs to the Hong Kong economy. While I was surprised by the size of the number, I would argue this is a gross underestimate. Once we take into account the amount of time which is freed up as MDWs take responsibility for childcare, their complete contribution to the economy is surely much greater. More importantly, if we take in the costs of the necessary development of the specialized elderly care sector, in terms of both institutions and domestic support, as well as personal social services if provided either by the government or the market, I suspect the costs saved by relying on the MDW model would make this HK$71 billion look like small change.
The professionalization of the care sector, starting with MDWs, represents a win-win for all ... As we transition toward a model where care is more directed toward our older population, which has much more heterogeneous care needs, we surely need to examine whether our current immigration system is fit for this purpose.