大城市養老 多主體發力

時間：2019-10-28 09:05:13 來源：iiijk.com

　　老齡化程度高、養老需求多樣，大城市養老難題如何解?廣州市針對不同層次、不同狀態老年人的養老需求提供服務，鼓勵市場力量做好專業的事，將政府力量聚焦監管與兜底保障，多主體共同發力，完善了大城市養老模式，老年人的獲得感幸福感安全感正不斷得到提升。

　　“當你老了，頭發白了……”抒情的旋律令人沉醉，更引人共鳴的，是歌詞里描述的場景。

　　隨著我國快速進入老年社會，城市如何養老，成了民生大事。作為特大城市，廣州更是其中一個典型。據統計，截至2018年底，全市老年人169.3萬，占戶籍人口的18.25%。

　　如何破解難題，滿足全社會多樣化的養老需求?如何發揮市場的調節配置作用?近年來，廣州一直在探索。

　　需求

　　不同老人需要不同服務

　　俗話說，“家有一老，如有一寶”，但也有“一人失能，全家失衡”的說法，老年人的狀態與家庭的生活質量息息相關。對于老年人來說，大抵可分為能自理、部分失能、失能三類，處于不同狀態的老年人，需求也不盡相同。助餐配餐、醫養結合、生活照料，是其中最迫切的需求。

　　午飯時間，廣州荔灣區東漖街居家養老服務中心的長者飯堂，很是熱鬧，“嘀”地刷下卡，就能現場點餐，還可以提前通過手機下單，兩葷一素一湯，米飯不限量。

　　92歲的葉五妹就經常推著66歲腿腳不便的兒子來吃，已經一年多了，“很方便，有時候來不了，義工就會送到家里�！�

　　除了吃午飯，葉奶奶也會和兒子參加一些服務中心的活動，打太極、聽養生講座、與老年人交流，遇到身體不舒服，還可以在中心的護理站看醫生，甚至能夠請護理人員上門提供生活照料、個人護理等個性化服務。

　　遇到家里實在沒法照顧的情況，怎么辦?

　　幾個月前，78歲的楊姨突然中風，出院后生活無法自理，85歲的梁叔一個人實在照顧不來。還好養老服務機構越秀銀幸頤園開到了社區，離家近，家人能隨時探訪，且有專業的護理人員照料，老人的狀態一天天好了起來。

　　“這種嵌入式養老服務機構能有效緩解大城市中心城區養老床位‘一床難求’的問題�！睓C構負責人何洪濤介紹道，“我們會先對老人的實際情況進行評估，再提供最合適的服務�！�

　　如果老人還能自理，但害怕有意外發生，工作人員就會推薦安裝家庭養老床位，對住家做適老化改造、安裝智能設備，記錄老人的生命體征和活動軌跡，一旦有異常，系統會自動報警。

　　長期或臨時托養、助餐配餐、上門照料、家庭養老床位……多樣的養老需求，催生多樣的養老服務，也能夠提升老年人的生活質量。

　　目前，廣州共有11個區級、153個街鎮級居家養老綜合服務平臺，全市社區養老服務設施覆蓋率100%，超過18.4萬名老年人享受社區居家養老服務，占老年人總數的10.87%。

　　市場

　　鼓勵社會力量進入

　　7年前的海珠區沙園路1號，還只是個舊廠房，地處市中心。其時，正值廣州市積極探索養老問題解決辦法，鼓勵市場力量進入該領域。

　　養老機構設立許可取消、審批手續精簡，在用地、床位等方面，還有優惠、補貼……這讓勞偉敏看到了機會。

　　“老城區，地理位置好，老年人又多，周邊也沒有類似機構，辦養老院大有可為�！眲趥ッ艟秃蛷S房所屬公司合作建設，開辦了松鶴養老院。綠樹成蔭，環境寬敞，花園式的養老院，有近900張床位。

　　一開始，松鶴的定位是高端養老院，收費不菲，開業近一個月，咨詢的人不少，但入住的人卻實在不多。在經過充分調研后，松鶴調整了策略，定位面向中端人群，價格也比剛開始下降了30%，入住的老人漸漸多了起來。

　　養老事業不是短期的事，對此，勞偉敏一直很清醒，“養老院的入住，前期靠宣傳、價格吸引，而后期，靠的就是口碑了�！�

　　抓環境、抓設施、抓服務，現在我們這里的入住率達到95%以上，還被廣東省民政廳評為“五星級養老機構”�？蓜趥ッ暨�是感到“壓力山大”。

　　“這幾年，政府大力鼓勵社會力量進入養老產業，門檻低了，但競爭更大，就是要優勝劣汰，發揮市場在養老服務資源配置中的決定性作用�！睆V州市民政局負責同志說。

　　眼下，廣州市73%的養老床位、85.5%的居家養老服務綜合體、91%的長者飯堂，均由社會力量提供，民辦養老床位占全市總床位七成，社會力量已成為廣州提供養老服務的主體。

　　“從養老機構的開辦，到養老床位的完善，再到長者飯堂食材的供應……社會力量的進入，意味著政府力量能夠有效解放出來，更多地放在兜底保障與引導監管方面�！睆V州市民政局負責同志表示，“專業的事，還是要交給專業的人去做�！�

　　公平

　　政府能兜底，群眾心有底

　　在被送到廣州市老人院之前，陳文均是“三無”(無勞動能力，無收入來源，無法定贍養人)人員。提到去敬老院，他轉身就走，誰的面子也不給。2016年9月，一場疾病襲來，陳文均倒下了，治療后就被送到了老人院。

　　“以前，別人跟我說，千萬不要去老人院，沒想到，來了之后舍不得走，工作人員態度好，院長還給我拿了新衣服來……多虧了政府照顧，我才能在這安心養老�！标愇木�說。

　　“像陳文均這樣的老人，屬于特殊保障對象，由政府兜底保障。我們公辦養老院必須承擔起這個社會責任�！睆V州市老人院副院長常廣財說。

　　政府能兜底，群眾心里才有底，才能避免因市場失靈而帶來的養老公平問題。

　　為此，廣州市民政局定期巡訪、主動服務，加強獨居、空巢、失能等老年人關愛服務體系;為“三無”、低保低收入、計劃生育特別扶助人員等老人購買居家養老服務、資助開展無障礙設施改造;率先建立全市統一、困難失能優先、公開透明的公辦養老機構入住評估輪候制度;還為全市所有老年人購買意外傷害綜合保險，資助10萬多名本市常住的失能、獨居、高齡老年人使用“平安通”智慧養老服務。

　　除了兜底，政府還注意扮演好引導者和監督者的角色。

　　廣州對養老產業發展進行有效引導，圍繞老人養老需求精準發力，強化頂層制度設計，深化養老服務供給側結構性改革，從一開始降低準入門檻，到給予多項資金支持，再到出臺用地規劃、出臺政策、出臺標準、評定星級，對市場的發展方向，既是鼓勵，也是規范。自2009年以來，市里累計投入資助民辦養老機構發展的資金達5.3億元。

　　政府監管，大數據可以成為有效利器。走進廣州市養老服務數據監測中心，大屏幕上，長者飯堂數量、全市助餐配餐申請人數、居家服務資助對象等數據，清晰明了。通過這個平臺，全市的養老服務情況能夠被精準掌握，再對數據分析，就可以合理整合服務資源，均衡分配補貼資金，同時能夠規范管理、防范造假，讓監管更加細致高效。

　　“大城市養老，必須依靠多個主體共同發力�！睆V州市民政局負責人表示，“下一步，我們還將繼續把大養老的工作做實做細。把長者大配餐、醫養結合、家政+養老、嵌入式養老、養老機構提質增效等民生品牌做深做精。完善‘大城市大養老’模式，構建全覆蓋、多層次、多支撐、多主體的養老服務格局，不斷提升老年人的獲得感幸福感安全感�！�

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