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Qualifications of Postnatal Carers Vary and Lack Clear Definitions Review Service Terms Carefully and Prepare Contingency Plan

  • 2021.10.18

To help new mums with postpartum recovery as well as to relieve the stress of looking after the newborn baby, many families choose to employ postnatal carers to take care of the new mum and baby’s daily needs. In view of the burgeoning of privately owned or non-governmental postnatal carer intermediaries and agents, the Consumer Council reviewed 19 companies/organisations providing postnatal care services and revealed that there was no universal definition for the qualifications of postnatal carers, not to mention the lack of objectivity for claims of “champion” or “ace” postnatal carers. Aside from the base salary, different companies/organisations generally have various additionally charged items and restrictive terms. Consumers preparing to give birth should carefully compare shortlisted services/packages before deciding.

Hong Kong currently has no regulatory framework on the professional qualifications of postnatal carers, making it harder for consumers to verify their relevant work experience. If the service quality of postnatal carers is unsatisfactory, or in case the intermediary company is unable to arrange the selected postnatal carer due to advanced or delayed arrival of the baby, parents-to-be should have a contingency plan and seek assistance from elder family members or domestic helpers to avoid throwing plans into disarray. Besides, consumers should verify whether the company/organisation providing intermediary service holds an Employment Agency (EA) Licence.

The Labour Department (LD) requires all persons operating an EA, regardless of the mode of operation or nature of vacancies offered, to obtain an EA Licence or Certificate of Exemption (CoE) before commencing operation. The LD responded to the Council that out of the 19 companies/organisations surveyed, 2 did not have any record of an EA Licence or CoE. LD has followed up on the matter.

Aside from postnatal homecare services, postnatal care accommodation packages have also become popular in recent years. As these packages flaunt a variety of postpartum services including accommodation, postnatal care services and baby care, the charge is relatively higher. These postnatal care accommodation plans usually last for 26 to 30 nights, with rates ranging from $63,800 to $268,000, a variance of over 3 times. As the services included in the various packages also vastly varied, consumers should visit the site in person and make detailed enquiries about the postnatal carer’s qualifications and professional standard before signing the contract, while bearing in mind a deposit of at least half of the total rate is required at the time of signing the contract. Whether hiring a postnatal carer or selecting a postnatal care accommodation package, consumers should confirm the service details and various charges, while ensuring all service terms are clearly stated in the contract to safeguard consumer rights.

This survey covered 19 companies/organisations offering postnatal care intermediary or agency services, including 17 intermediaries and 2 non-governmental organisations that provide postnatal carer training courses. In addition, the Council also reviewed 18 postnatal care accommodation packages provided by 4 postnatal care centres, hotels or intermediaries, and compared their service scopes, quotations, qualifications of postnatal carers, and arrangements under specific situations.

Postnatal Homecare Service

From the service details collected, it was found that the rates of postnatal carers were generally based on the experience and working hours, which ranged from 8 to 24 hours per day, and from 22 to 26 days a month. Although postnatal carers are ranked according to their postnatal care experience, there is a considerable discrepancy in how different intermediary companies or organisations would categorise or define the experience of a postnatal carer with the same qualifications and experience. For example, the claimed experience of a “senior postnatal carer” could range from having attended to 4 to 100 babies. As a result, it is difficult for consumers to make a direct comparison of the experience of postnatal carers. If a postnatal carer with 30 times of relevant experience is hired to work for 8 hours a day for 26 days, excluding 1 organisation which did not provide a quotation, the remaining 18 companies/organisation provided quotations ranging from $21,000 to around $34,000, a difference of over 60%.

Apart from the base salary, postnatal care services also entail other additional charges. Amongst the 17 intermediary companies, 7 would charge an administration fee of up to $6,800 upon successful matching of postnatal carer with an employer. If cross-district commute is required by the postnatal carer or if the employer lives in a remote area, most organisations/companies request the employer to bear the transport expenses in full or partially. Besides, 9 intermediary companies/organisation require the employer to give a red packet to the postnatal carer on their first day and last day of service though the amount is not specified. If the postnatal carer is requested to prepare Chinese ginger vinegar before commencing service, some companies charge an extra service fee of $500 to $3,000.

Furthermore, all employers are mandated by the Employees’ Compensation Ordinance to take out employees' compensation insurance for employees to cover their liabilities under the laws (including the common law) for injuries at work. As such, if an employer-employee relationship exists between the consumer and the postnatal carer, the consumer is required to take out employees’ compensation insurance accordingly. Except for 5 intermediary companies which covered the insurance premium in their service charges, 10 intermediary companies expressed that the employer must purchase the insurance themselves, with the 3-month insurance premium ranging from $199 to $600, a difference of around 2 times.

Owing to the considerable number of variables related to childbirth and selection of postnatal care services, consumers should contact related organisations well in advance to understand the arrangements and charges under different circumstances. For example, a customer might need to request a change in the postnatal carer’s employment date due to advanced or delayed delivery. To allow the employer to make necessary changes, 14 intermediary companies/organisations would reserve the postnatal carer’s schedule before and after the due date, ranging from 7 days before and 4 days after the due date, to 10 days before and 10 days after the due date. If service is required for an even earlier date, a replacement postnatal carer might be arranged. 4 companies did not provide a buffer period, but claimed that if the selected postnatal carer could not start work at an earlier or later date, they would arrange for a replacement. Besides, 15 companies or organisations provided a probationary period of 3 to 7 days. If the performance of the postnatal carer is unsatisfactory during probation, 11 companies allowed for a replacement once to twice, or even unlimited number of times. If the employers could not select a suitable replacement postnatal carer within the probationary period, 7 of them stated that no refunds would be given.

The payment arrangement should also be paid attention to before confirming the employment of the postnatal carer. 1 company expressed that only an administration fee but not a deposit is required at the time of signing the contract; the remaining 17 all requested the customer to prepay a portion of the costs as deposit on the day of signing the contract, amongst which 2 asked for a deposit equivalent to half of the postnatal carer’s wage. As for settling the outstanding payment for the postnatal carer’s wage, 3 companies requested that the payment be settled before the postnatal carer commences work, amongst which 1 even requested the payment be made after the fetal morphology scan.

Consumers should note that in the event of service cancellation due to personal reasons, 14 intermediary companies/organisations would not offer a refund. If the service is cancelled due to health issues, such as miscarriage, 1 stated that a refund would not be given; 2 companies declared that if the service is cancelled after 12 weeks of the pregnancy, the deposit and administration fee would be forfeited.

Postnatal Care Accommodation Plans

The Council surveyed 18 postnatal care accommodation packages provided by 4 companies. Besides a vast variance in the rates, 2 packages stated that postnatal care services would be provided for only 8 hours a day, but not 24-hour support, so the consumer would need to make their own arrangements for the remaining time. The postnatal care service for 7 packages were provided on a roster basis instead of an exclusive one-on-one service. If the customer is dissatisfied with the service quality of the postnatal carer, 3 companies expressed that as postnatal carers are arranged by roster, replacement cannot be guaranteed.

Postnatal care accommodation packages cover a broad service scope, from accommodation, postpartum care, meals, to beauty and body toning, etc. Out of the surveyed packages, 12 advertised nursing rounds by nurses or midwives whereas 3 indicated that postpartum care such as breast examinations, wound checks and care would be provided. In addition, 4 packages provided Chinese medicine consultations for 1 to 5 times in total, or once a week. Consumers should pay heed to the qualifications and professional standards of the relevant service providers, including Chinese doctors, nurses or other healthcare providers, so as to ensure the service quality.

As for the deposit payment, 3 companies stipulated that half of the total rate should be paid as deposit, while 1 required a full payment at the time of signing the contract. After paying the deposit, if the consumer requests service cancellation due to personal reasons, all 4 companies stated that a refund would not be given. If the cancellation is a result of health reasons, such as pregnancy issues of the expectant mother (such as a miscarriage), upon submission of doctor’s proof that accommodation is not recommended, 2 companies would refund the deposit after deducting a portion of the amount, for example 10% of the deposit as administration fee.

When selecting postnatal care or postnatal accommodation services, consumers should pay heed to the following:

  • Enquire with different intermediary companies or service organisations to clearly understand the definitions of various postnatal carer qualifications and the rates, and only engage reputable companies or organisations. Also enquire whether they hold a valid EA Licence or CoE, if consumers plan to employ the postnatal carer as a direct employee;
  • Seek referrals from friends and relatives for more experienced and reputed postnatal carers;
  • If the employer has any special work requirements, it should be discussed with the postnatal carer beforehand and clearly stipulated in the contract;
  • Review the proof of qualification of the postnatal carer and prepare interview questions in advance to test their knowledge of infant care and postpartum care;
  • If a work trial is preferred, employment conditions should be clearly negotiated in advance to reach a mutual agreement;
  • Peruse the contract details carefully before signing, including the names and HKID numbers of both the employer and employee, work commencement and end dates, work hours, work scope, wage, calculation of pay for overtime or extra work, probationary period, deposit arrangements, and arrangements for termination of contract before or within the employment period by either party, etc.;
  • Examine the service mode and details of the postnatal care accommodation packages, pay heed to whether the contract terms include the arrangements for early termination of contract, the responsibility and liability of both parties, as well as relevant arrangements if unable to check into the accommodation as planned.

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