|
鼓勵生育 不要空談「有仔趁嫩生」/ Encouraging does not equal interfering, create a conducive environmen
文章
2023 年 11 月 1 日
行政長官李家超上周三(10月25日)宣讀了3個半小時的施政報告,當中涵蓋多個政策範疇,並接納了新民黨至少15項建議,反映行政長官有願意聆聽和廣於接納的氣度。本篇集中討論有關人口政策、鼓勵生育的內容。
香港出生率低、人口老化是不爭事實。2018年至今,香港的出生率由1.08跌至0.701。正如施政報告第113段提到,「本港夫婦平均子女數目下降至2022年的0.9名新低點。同時,香港是全球最長壽的地區之一,65歲及以上長者佔全港人口比例,將在未來十年內由兩成攀升至近三分之一。」
鼓勵不等於干預 締造有利環境
今年2月8日的立法會大會,勞福局局長孫玉菡回答新民黨容海恩議員的口頭質詢時,說「……生兒育女是家庭的重要決定,政府會推出各項措施,為有意生育的人士提供更好的支援,但不宜過分干預」,我並不認同,鼓勵並不等於干預。
猶幸現在行政長官察知社會有實際需要,因此施政報告以〈鼓勵生育,締造有利育兒環境〉為篇,指出「政府必須有政策導向,鼓勵生育」,我認為方向正確。其中,很高興行政長官接納了新民黨於2022年起提出的建議,向父或母為香港永久性居民的新生嬰兒發放2萬元獎勵金。市民大可把2萬元當成是「大利市」,皆大歡喜,反映特區政府重視生育,而不是說市民會貪圖這2萬元便立即生、生、生。
此外,我贊成推出「家有初生優先配屋計劃」和「家有初生優先選樓計劃」,讓家有新生嬰幼兒的家庭優先上樓(公屋)、選樓(居屋),期望有需要的家庭能受惠。
應對人口老化方面,除了優化各項安老服務,很欣慰行政長官接納新民黨建議,成立「銀髮經濟顧問小組」,研究銀髮經濟的發展潛力。新民黨一直主張,長者不是負累,很多長者充滿活力又具消費力,他們是社會資源,我期望這個小組認真檢視長者群體的消費行為及需求,並提出切實可行的建議。
輔助生育增名額扣稅 屬好開始
回說鼓勵生育,新民黨最早提出,為使用雪卵等輔助生育科技的女性提供5萬元資助,鼓勵有需要的女性作更靈活的生育及家庭計劃。喜見今次施政報告終有涉獵這範疇,認同社會有此需要,把接受體外受精治療服務的公營名額,由每年1,100個,增加六成至1,800個;同時增設輔助生育稅項扣除,我認為是好的開始,期望特區政府會繼續提出鼓勵運用輔助生育科技的措施。
不過,我對於醫務衞生局局長盧寵茂教授多次公開發言,指市民對輔助生育工具有錯誤觀念:「覺得雪個卵將來生完全無問題」,指市民「以為雪卵生仔很簡單」,又說「從醫療角度上說,30歲前同40歲後生完全兩回事」,還高聲呼籲「有仔趁嫩生!」我並不苟同。
女性遲生育 惟實際處境遭漠視
誠然,純粹從醫學角度來說,誰不知道女性在年輕身體好的時候生育最理想,可是這個說法完全漠視了香港現今的社會實況及女性面對的實際處境。
我們來讓數據說話,根據特區政府2021年人口普查,在香港7,093,081人口(不包括外籍家庭傭工)中,女性佔52.35%(3,712,977人),男性只佔47.65%(3,380,104人),即是女多男少。
以學歷程度計,在女性人口中,取得學位或研究院以上學歷的,佔19.82%(736,008人);在男性人口中,取得同等學歷的有20.86%(705,033人),即是同為高學歷的也是女多男少。
以適婚年齡計,在女性人口中,20至44歲佔31.3%(1,161,808人);在男性人口中,20至44歲佔31.4%(1,075,911人),都是女多男少。
以從未結婚的狀況計,在女性人口中,20至24歲從未結婚的高達95.34%(148,283人);25至29歲79.57%(170,091人);30至34歲45.64%(109,869人);35至39歲25.17%(67,508人);40至44歲19.84%(56,267人),即是女性遲婚者多。
以上數據反映的香港實況就是,香港女多男少,女性在擇偶或婚姻上面對很大競爭。香港女性在完成學業後,鮮有立即結婚,而是投身工作,發展事業,同樣面對本地或內地女性的競爭,待至稍有少成,有經濟基礎,有空間考慮結婚或生育,轉眼已年過30甚至40歲,即是大部分香港女性均未能做到盧局長所說的「有仔趁嫩生」,這是客觀存在的事實,希望盧局長多了解這些數據及背後反映的問題。
再者,我亦不認同盧局長所指,市民會「以為雪卵生仔很簡單」。事實上,女性採用輔助生育科技,不單要付上巨額費用,肉體上要經歷多重複雜而痛苦的步驟,還有漫長的等待,而且未必一次成功,要承受失敗的煎熬,我不認為會有女性因為特區政府提供了資助,便刻意雪卵或者刻意遲生,這是說不過去的;呼籲「有仔趁嫩生」也是無視了女性承擔的痛苦。
歐亞積極支援生育 港遠未追上
事實上,很多國家也面對出生率下降的問題,並對採用輔助生育科技的人士有不同程度的支援。例如英國修改《人類受精和胚胎學法》(Human Fertilisation and Embryology Act),將卵子、精子及胚胎的最長儲存期限由10年一律提高至55年。法國由國家醫療保險全額補貼43歲以下女性接受生育治療的費用。以色列為年齡18至45歲女性提供接近全額資助,讓其無限次接受體外受精療程,直至其與現有伴侶育有兩名子女為止。
鄰近國家也比香港走得前,日本已把「不妊治療」納入醫療保險報銷範圍,高達70%的生育治療費用可透過醫療保險發還;40歲以下女性最多可獲資助6個輔助生育科技治療療程。新加坡為符合條件的已婚夫婦提供最高75%的輔助生殖技術治療費用補貼,並允許他們動用國民儲蓄計劃下的醫療帳戶來支付手術費用。
由此可見,特區政府在支援市民採用輔助生育科技方面,遠遠未追上其他國家的腳步。盧局長宜認真審視數據和需求,體察女性面對的困境,參考其他國家的做法,為本港女性提供適切支援,真正做到鼓勵生育,不要再空談「有仔趁嫩生」。
Encouraging does not equal interfering, create a conducive environment
During a question-and-answer session at the Legislative Council meeting on February 8 this year, Secretary for Labour and Welfare Chris Sun answered the oral question from New People's Party legislator Eunice Yung, saying "childbearing and child-rearing are important decisions for families, and the government will introduce various measures to provide better support for those who want children, but should not interfere excessively." I do not agree that encouraging equals interfering.
Fortunately, the Chief Executive is now aware of the actual needs in society. The Policy Address addresses "Encouraging Childbearing and Creating a Conducive Environment for Child-rearing," noting that "the government must have policy orientation to encourage childbearing," which I believe is the right direction. Gladly, the Chief Executive accepted the New People's Party's proposal since 2022 to give a HK$20,000 incentive to newborn babies with a parent who is a permanent resident of Hong Kong. Citizens can treat the $20,000 as "red packet asin festuve seasons", everyone being happy, reflecting that the HKSAR government cares about childbearing instead of citizens bearing children hastily for the $20,000.
In addition, I support launching the "Priority Housing Allocation Scheme for Households with Newborns" and "Priority Flat Selection Scheme for Households with Newborns" to give priority to families with newborn babies and infants in public housing allocation and selecting housing property. Hopefully families in need can benefit.
With regards to addressing population aging, in addition to optimizing various elderly services, I am glad the Chief Executive accepted the New People's Party's proposal to establish a "Consultative Group on Silver Economy" to research the development potential of the silver economy. The New People's Party has always believed that the elderly are not a burden. Many elderly are active consumers, and they are a social resource. I hope this group will seriously examine the consumption behaviors and needs of the elderly group and put forward practical feasible proposals.
Deduction for fertility aids represent a good start
To discuss encouraging childbirth, the New People's Party was the earliest to propose providing HK$50,000 subsidy for women using assisted reproductive technologies such as IVF, to encourage women with need to make more flexible plans for childbearing and family. Glad to see this Policy Address finally touched on this area, recognizing the social need, and increasing the annual public quota for women receiving in vitro fertilization treatment from 1,100 to 1,800, a 60% rise , which I believe is a good start, hoping the HKSAR government will continue to propose measures encouraging the application of assisted reproductive technologies.
However, I do not agree with Secretary for Food and Health Prof Lo Chung-mau's repeated public remarks claiming citizens have "misconceptions that IVF will definitely lead to pregnancy" and that citizens "think IVF makes it easy to get pregnant." He also said "from a medical perspective, having a baby before 30 is completely different from after 40," and loudly calling on people to "have children while young."
Delayed childbearing overlooks women's actual circumstances
Indeed, purely from a medical perspective, no one doubts that it is most ideal for women to bear children when they are young with healthy bodies. But this view completely ignores Hong Kong's current social realities and actual circumstances facing women.
Let's let the data speak. According to the 2021 Population Census of the HKSAR government (excluding foreign domestic helpers), of the 7,093,081 population, women accounted for 52.35% (3,712,977) while men only accounted for 47.65% (3,380,104), meaning there are more women than men.
By education level, among the female population, those with a degree or postgraduate education accounted for 19.82% (736,008); among the male population, those with equivalent education accounted for 20.86% (705,033), meaning more highly educated women than men.
By marriageable age, among the female population, ages 20-44 accounted for 31.3% (1,161,808); among the male population, ages 20-44 accounted for 31.4% (1,075,911), both with more women than men.
By never married status, among the female population, never married rates were as high as 95.34% (148,283) for ages 20-24; 79.57% (170,091) for ages 25-29; 45.64% (109,869) for ages 30-34; 25.17% (67,508) for ages 35-39; and 19.84% (56,267) for ages 40-44, showing many delayed marriages among women.
The above data reflects Hong Kong's reality - more women than men, with great competition for women in choosing mates and marriage. Hong Kong women focus on completing their studies and careers after graduating, also facing competition from local and mainland women. By the time they have some achievements and economic foundation to consider marriage and childbearing, they have already passed 30 or even 40 years old. This is an objective fact that most Hong Kong women cannot achieve what Secretary Lo advocates of “having children while young”. I hope Secretary Lo can understand these data and underlying issues more.
I also do not agree that citizens would think "IVF makes pregnancy easy" as Secretary Lo claimed. In fact, women undertaking assisted reproductive technologies have to go through complex and painful procedures repeatedly at huge costs physically and mentally, with a long waiting period and no guarantee of success, bearing the agony of failure. I do not think women would deliberately choose IVF or delay childbearing just because the government provides subsidies. This claim is untenable and ignores women's suffering.
Northeast Asia actively supports childbearing while HK lags behind
In fact, many countries also face declining birth rates and provide different levels of support for those using assisted reproductive technologies. For example, the UK amended the Human Fertilisation and Embryology Act to universally extend the longest storage period for eggs, sperm and embryos from 10 to 55 years. France fully reimburses fertility treatment costs through national health insurance for women under 43. Israel provides almost full subsidies for women aged 18-45 to undergo unlimited IVF cycles until they have two children with their existing partner.
Neighboring countries have progressed more than Hong Kong. Japan has incorporated "infertility treatment" into medical insurance reimbursement, with up to 70% of fertility treatment costs reimbursable. Women under 40 can receive subsidies for up to six assisted reproductive technology treatment cycles. Singapore provides subsidies of up to 75% for assisted reproduction techniques for eligible married couples, and allows them to use their Medisave medical savings accounts to pay for surgery fees.
It is evident that the HKSAR government lags far behind other countries in supporting citizens' use of assisted reproductive technologies. Secretary Lo should seriously examine data and needs, understand women's predicaments, reference other countries' practices, and provide women with appropriate support to truly encourage childbearing instead of just empty talk of "having children while young."
|