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No matter how stubbornly the government had resisted increased social expenditure and how firmly it had collaborated with the business and professional elite in rejecting social reforms until the 1970s, the development of health, education and welfare services could not be suppressed indefinitely. The government had eventually accepted responsibility for providing more and better public housing and social services. This commitment was not to last, however. In the new century, not only did the government seek to limit its social responsibilities but the reforms of the last two decades were deliberately reversed. A dismantling got under way of the social service programmes. Some features of the 1990s system simply disappeared: the provision of virtually free hospital treatment for the entire community, for example, and access to the best government-subsidised schools regardless of family income. The quality of services was also under threat. The professionals were able to defend standards for some services more successfully than others. Hospital care in general withstood the destructive pressures of austerity better than post-secondary education, for example. The situation was further complicated by government innovations which were supposed to offer more modern and efficient solutions to social problems, in particular the management of welfare services provided by non-governmental organisations (NGOs). In practice, waiting lists remained disgracefully long, regardless of the severity of the physical and mental distress of those in need of care. In reviewing this often chaotic and confusing process, this chapter can only seek to identify the most seriously harmful developments and to highlight some of the more glaring examples of the new poverty and the damage that government policies were inflicting on particularly vulnerable groups. The retreat from the government’s commitment to decent social services was all the more rapid because it had got under way — largely unnoticed by the community — even before the 1997–98 Asian financial crisis. Business leaders had fought vigorously against improvements 5 Social Reforms: The New Poverty 140 Poverty in the Midst of Affluence in social programmes during the 1990s.1 Senior officials mostly shared the business community’s conviction that the public sector was inherently wasteful and less efficient than the commercial world. The colonial administration had embarked on schemes before 1997 to seek greater value for money in the housing field, for example, and to increase cost recovery in public hospitals.2 The Social Welfare Department, the previous chapter explained, was supposed to adopt a private sector approach and transform the existing system for subsidising the welfare services into contractual undertakings with non-governmental organisations (NGOs). These had warned the government in 1995–96 that they would be unable to operate effectively under such an arrangement, which officials confessed was ‘a genuine and justifiable concern’. Their reservations were disregarded, however, both before and after 1997.3 Without the consultancies and blueprints that were commissioned to promote a business culture within the public sector during the closing years of British rule, the retreat from the reform initiatives of the 1990s could not have taken place so quickly in the new century. As the economy went into recession during 1997–98, the momentum to dismantle past reforms gathered speed. The government faced no significant opposition to its claims that welfare had become unaffordable and that expansion of the social services was unsustainable. Fees and charges were raised, and cuts took place in the range of benefits provided through social security and by the social services in general. Health: Painful Cuts Hospitals were a prime target for cutbacks, partly because universal, low-cost public medicine looked like ‘welfarism’ at its worst, and the ruling elite wanted to boost the private sector. The modernisation of the hospital system in the 1990s, ironically, had made it easier for policymakers to undo its achievements. The Hospital Authority had become a free-standing statutory body, and the government’s duty to allocate adequate funding in the annual Budget was thus obscured. Officials could now distance themselves from the supply of hospital services and from responsibility for their finances, creating the impression that it was the Authority’s fault if it had cash problems which affected the quality of hospital care. The separate status of the Hospital Authority also made it easier for the government to adopt the role of outside observer and to blame the victims for the unsatisfactory state of the health services. In 2005, the second Chief Executive, Donald Tsang Yam-kuen, provoked outrage by claiming that older people exaggerated their ailments. They queued at government...

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