Discussion keeps the world turning.
This is Roundtable.
Beijing and Shanghai are rewriting the rules of aging, and not with vague policies either, but with care networks built into neighborhoods, hospitals and daily life.
The changes are real, to new service models on the ground and, for the first time, a national certification turning elder care into a recognized profession.
We'll learn all about that today.
Coming to you live from our studios in Beijing.
This is Roundtable.
I'm Steve Hatherly.
Thanks for being with us today.
And for the show, I'm with Yushan and Xinyu.
First up.
China's major cities are entering a new phase of aging, where the challenge is no longer about expanding coverage but about redesigning how care is actually delivered.
In both Beijing and Shanghai recently rolled out.
Elder care solutions are beginning to take shape not as abstract frameworks, but as visible service systems embedded into neighborhoods, hospitals and daily urban life.
Alongside new service models, a new layer of professionalization is also emerging, including the formal introduction of what is called the elderly care service professional, a nationally recognized qualification designed to structure and upgrade China's elder care workforce.
Xingyu and Yuxuan, good afternoon.
Good to see you both.
Yuxuan, let's start with a little background on, before we get to the policy changes and the new education that's available.
Let's find out maybe why it's a necessary move.
Yeah.
Actually, China's elderly care industry is quite, I think, popular in recent years, but also it's under growing pressure as the country's population ages rapidly.
And today more than 320 million people in China are over the age of 60.
And the number is expected to exceed 400 million by around 2035.
And as demand for long-term care continues to rise, this sector faces a serious shortage of qualified professionals and also specialists.
And beyond the lack of workers, there is also a growing need for more specialized services, including rehabilitation, dementia care and also care planning.
So skills that many frontline caregivers are not trained to provide, because now maybe we have still a certain amount of frontline caregivers.
And so all of these kind of challenges and and build a more professional workforce is kind of urgent or is in need.
It's kind of a kind of an upgrade to the entire industry then.
All right.
Let's we'll talk about Shanghai and Beijing a little bit later on.
But let's talk about the new role.
Elderly care service professional.
Yeah, actually, the new role was created in 2025.
So that's last year.
And we are all very familiar with caregivers in the elderly care industry.
But now, Compared to caregivers, elderly care service professionals, they're more like all-around experts.
They have knowledge in medicine, rehabilitation, psychology, and nutrition.
So they're not just the frontline caregivers.
They are more like care managers.
The overseers.
The overseers, yes.
And the latest is that in June, the Ministry of Civil Affairs and the Ministry of Human Resources and Social Security introduced this national qualification system for elderly care service professionals.
So there was a gap that existed before now?
So before the regulation there were no senior care related positions in the National Vocational Qualification Catalog.
And that catalog is China's official list of jobs that either require a government license, like teachers and doctors, or lawyers you need a certificate or have optional skill certificates, like translators or IT techs.
But in the past, there were no senior care related jobs entered in this catalog.
And now, And now we have an elderly care service professional joining in this directory.
And China has established a more professional status for this industry.
So it's not like the job of senior caregiver didn't exist before.
Is that you couldn't get this nationally standardized certificate, as you would for IT or translation or other jobs that you mentioned?
But now with this change, you will be able to do that.
You will be able to get that.
It's more like we used to have more practitioners and people who get their hands on or they're actually doing these kind of things in this area.
And this national vocational qualification catalog is is kind of managed by the Ministry of Human Resources and also Social Security and it is updated periodically.
And that's why there are, I think we have a lot of discussions or topics on okay, we have newly added job occupations now in this catalog.
And now the current version is the 2021 edition.
And this kind of catalog serves as the authoritative reference to ensure that only qualifications within it are officially recognized by the state.
So what about the people who were working in the industry before?
It's not that they were completely unqualified to do so.
Yeah, this kind of elderly care service specialist or professionals they are adding to this new catalog for the first time.
But unlike the existing caregivers certificate, which focuses on hands-on care, and the new credential trains professionals in care planning and also assessment and service management.
They do not replace each other.
But in fact having prior nursing experience can be an advantage for obtaining the new qualification.
And this reform is designed to build a kind of better talent pipeline and enhance the professionalism and standardization of the whole elderly care service industry.
So the existing certificates like senior caregiver or long-term caregiver or whatever the certificate says, those belong to a vocational skills system.
So it's not related really to what's being offered now.
So they are actually two different systems.
I think in the past, when we talk about caregivers, they have received the training from a certain elderly care institutions or organizations and then they start work and then, Before that time, there was no certificate.
It's just training and you've received training and you can start working.
But now we have sort of for these hands-on workers or frontline workers.
You have to achieve a certain kind of certificate to actually get things done.
But for now, this new system is for another profession.
It's the elderly care service professional.
And a new system is for them.
So the two systems are not contradictory.
They're going to run parallel to each other.
Very good.
Okay, so what types of things are required of the position then?
What are they exactly responsible for if we look at some specific details?
They have to kind of learn through different curriculum and there are some areas they need to learn.
Theoretical knowledge is one thing, like including care assessment, care planning, risk management, relevant laws and also regulations, aging-friendly environments and ethics.
And also they need to grasp the practical management skills such as developing personalized care plans, overseeing service quality, coordinating health care and community resources and also training other care workers.
It's a lot.
Yes.
So these kind of things are like it's more of a management position, I feel.
So programs typically combine classroom learning, hands on practice and supervised fieldwork, with a total of around 120 to 200 hours of training, depending on the qualification level.
So when they get into this field then, there's a career ladder?
Is this something where you start at the bottom and are able to progress?
Or is there just one certificate available for the one kind of job title that we talked about?
Hmm.
Yeah, for these elderly care service professionals.
The new system offers three levels junior, intermediate and seniors.
Just like if you're a teacher.
So when you first become a teacher, then you are like an entry level teacher.
But then after like several years of work experience and you can become an intermediate teacher.
And you need to kind of publish some thesis.
Yeah, some journals.
Yes.
And then qualified as a more, you know, senior teacher or something like that.
Yeah.
So for this profession too junior and intermediate levels they will have this unified national exam with standardized question and schedules.
And if you pass this exam, you'll be given this, let's say, junior or intermediate certificate.
Whichever one you study for.
Yes.
And then you can be hired to a certain organization.
You can start working.
And after several years of working, you can apply for the next level.
And that is essential because the level is strictly tied to your pay.
So the higher level means the higher pay you can get.
And that's good for motivation for your career.
If you're interested in advancements, those are available to you.
Talking about experience, Yushan, I think you mentioned it already.
You have to have a certain amount of real job experience.
Is that something that you get during a program, or is that something that you need to enter into the program?
Yeah, there are some basic or fundamental needs or requirements that you need to meet, right?
And this kind of qualification places a heavy emphasis on practical experience to ensure that it doesn't become just a piece of paper, because you need to make sure that you are really capable of not only these practical exercises but also some theoretical management issues that you can handle.
So there are relevant degrees that you can have.
Even graduates with a bachelor's degree in senior care management must also have three years of frontline work experience before they can sit for the intermediate level exam.
Wow.
So maybe for the junior level, for the entry level, maybe that's not required, but to get to the next level, the intermediate, you have to have three years of experience within the field.
That's really good.
It's very...
It's a lot, right?
Three years of experience is a lot, but it's guaranteeing that people are going to know, before they move to the next level, exactly what the industry is about.
And I also think it is guaranteeing that it is really giving the certificate to the people who are in this industry because Actually, there are a lot of people who are really hardworking, they're really good at doing exams.
So you can think of somebody who are really good exam.
They are just getting one certificate after another.
And then they were just getting probably the highest level, but they are actually probably only know the theoretical knowledge, but they're not a practitioner in this area.
You also, yes, you can have a bachelor's degree in senior care management.
That will be an advantage for you because your work experience, your frontline work experience, will be limited to three years in terms of what you need for the intermediate level exam.
If you don't have a bachelor's degree in senior care management, you can have a degree in another major.
You can apply for the exam, but they say that it generally requires an additional year of work experience compared to those with relevant degrees.
So maybe four years work experience if your degree is not in that field.
Yes.
Yeah, and I think what makes it significant is that in the past for a caregiver, usually they are middle-aged female workers. caring for the seniors with limited mobility or cognitive impairment.
And they can work in the field for decades, for 10 years or 20 years, and the pay is the same.
And they cannot see the career prospects.
But for this new system.
I think that I can see that the country is trying to retain more talents, younger talents, to join in this industry, because we can guarantee that if you join here you can have brighter future, not just working for decades and with the same title.
You can just climb the ladder.
Yes.
So that's the growth opportunities.
Yeah.
All right.
Well, let's talk about – I mentioned it before that Beijing and Shanghai have made some changes.
Let's talk about these changes now.
We'll start with Shanghai, I guess.
And I guess we'll start with Shanghai, because Shanghai has one of the – fastest, or maybe most advanced cases, is the way to put it, of aging populations in the country.
By the end of 2024, Shanghai had 5.78 million registered residents aged 60 and above.
That's accounting for nearly 38 percent of its registered population, meaning that more than one in three residents is now elderly.
So, in one of the responses, starting 1st of July in 2026, Shanghai is launching a formalized elderly medical escort service.
And the service is designed for all residents that age 60 and above in Shanghai, with no residency restriction, which means that if you have a hukou or that kind of system that registered you as the residents in that area,
Or you can be not born and raised in Shanghai.
It doesn't matter.
Both local and elderly people and elderly visitors from other cities can access it.
And it also provides additional support for low-income and vulnerable seniors through some subsidies or public welfare resources at the district level, which means that when you're living in that basically community and also compound, this community will be responsible for all of these support and service for you.
So that means helping out with the registration and guiding them through the medical facilities.
Maybe people aren't familiar with that particular facility that they're visiting.
They also help out with communication between the doctor and the patient.
So i guess they come into the doctor's office with you, into the room um, so that they can help with ex the explanation of things.
They support administrative procedures and they also provide medication reminders, which is a really nice kind of little cherry on top.
And then, you know, your basic emotional support, I suppose, as well.
That would come from all of those things.
It's a really nice thing that they're doing there in Shanghai.
Who's providing this, by the way?
Is it just one provider or does it come from different places?
Yeah, there are two types of providers.
One is existing elderly care service institutions in Shanghai, and also specialized companies like, whose core business is elderly hospital escort services.
And these organizations are officially registered or filed with civil affairs authorities.
So they are required to employ a minimum of five professionally trained companion caregivers.
Okay, so the people who work there, the companion caregivers, as you called them, those are certified professionals.
Yes, they have to have some sort of certification.
Yeah.
Yeah, they must pass a special occupational skill assessment.
They are issued official identification badges by Shanghai Outerly Care and Aging Industry Association confirming that they have their qualifications.
And we kind of also talked about this profession before.
It's called companion caregivers or 陪診師.
It's no longer, because the first impression that I encounter this word is that okay, the people who will accompany an elderly to go to the hospital and then tell them okay, which window you should go to and what kind of medicine you should fetch, and remind you about the time of having the medicines and everything.
And now...
It is another whole new level of the companion caregiver because they have all of the, I think, more professional knowledge on telling and guiding the elderlies on how to not only take care of themselves but also giving them advice and real medical knowledge.
Yeah.
It's very comforting.
I'm thinking of myself in that situation.
And if you could have somebody come to your home pick you up.
They're a trusted certified professional from a trusted certified agency.
You don't have to worry about anything.
You don't have to worry about communicating with the doctor getting to the hospital.
Where do I go when I'm inside the hospital?
They even help remind you or help remind me of when to take medication.
I mean, this is a really wonderful service that's provided.
All right.
So that's Shanghai.
Now let's pop over to Beijing, also undergoing some changes here.
Although the percentage of the population aged 60 and above is lower than that of Shanghai, Beijing still taking the reins on changes too.
Yeah, but still the number of Beijing's aging population makes up of 23.5 percent.
So that's over 20 percent.
You can see that the city is also aging very quickly.
And on January 29th, the Beijing Municipal People's Congress passed this bill.
Beijing senior care service regulations and it took effect on July the 1st.
So this regulation aims to formalize, standardize and systemize senior care in this capital city by covering the entire service process.
So basically, the city is establishing a hierarchy consisting of district level guidance centers to street or township level regional centers and then community village level service stations.
So from the bigger district to the street that you're living and even smaller to your community.
So how does that work then?
So basically, it's a more coordinated supply system that bridges the gap between the government's planning or the government's regulations to actually individuals' needs of what you need or what you expect from this elderly care.
And for this district level guidance centers, they act as the top level coordinators.
So they provide like oversight, guidance and strategic planning for senior care across the whole district.
And for street or township regional centers, they serve as the hubs for specific neighborhoods.
And Beijing aims for these centers to have an 80% coverage rate.
So whenever you have a certain kind of need for elderly care, you can reach out to the community or the village that you're living in.
It's kind of fixing that last problem.
We talk about it in delivery, right?
The last mile problem.
It's kind of the same thing here, I feel like, where you have services that are physically reachable for residents, meaning they can get there within their own neighborhood and they don't have to worry about that.
Right.
But also I think it is a more comprehensive way of giving people support, because what I can see is that it's not only about these kind of medical services or accompanying.
It's also about the whole idea and mindset of these communities.
They are setting up an environment for, I think, the quality life of the elderlies, because in my community complex, it is a quite old place.
Very old.
Yeah, we mentioned it before.
But the thing is that they will have a lot of activities like teaching elderly how to use smartphones, how to use tablets or how can they get access into, let's say, national health care service system.
There are little courses like that, or there are some parent-child time that you can organize.
Of course, mostly there will be elderlies and their grandchildren to participate in these activities.
But the thing is that I think they are really taking care of all of the aspects of the life of these elderlies.
Covering as many things as they can.
And they're covering as much of the city as they can, too.
Xinyu, what was that stat you just shared?
They want an 80% coverage rate by the end of the 15th five-year plan.
So that's 2030 when that will wrap up.
And they're doing a good job so far.
It seems like they're ahead of schedule, actually.
I don't know that, but it feels like that.
Because they already have 13 district-level centers, so they only have three districts left.
And they are set to come online by the... Well, right around now, actually.
Mid-2026 is the goal there.
So they're already... covering as much of the city as they possibly can.
All right.
So on the service supply side of things, I asked the same question about Shanghai.
Who's involved?
Who are the service providers here?
And it seems like Beijing is interested in perhaps even making a more diversified mix of providers.
Is that would that be an accurate statement?
Yeah, so the city is encouraging a more diversified mix of providers, including social organizations and enterprises, to participate in this elder care in the city.
And we also have policies that promote the integrated use of urban space by allowing mixed-use development of land for elder care.
We talked about this before.
Yeah, maybe for those non-residential properties they are being repurposed for elder care facilities or more flexible leasing arrangements to support long-term operation.
And maybe for those leftover land parcels in old neighborhoods or idle commercial or industrial buildings or former schools.
They can be repurposed into elder care facilities.
That's good.
So that's one of the One of the tangible changes we can see then.
What else?
I'm curious to know.
Because when we talk about policies, we use a lot of fancy language, right?
And we talk about programs and certificates and things like this.
But what does it actually look like when we get out there, if you know what I mean on a daily basis?
So these kind of things are reflecting, as I said, in a lot of aspects of their daily lives, like enterprises or these restaurants.
They are, I think, cooperating with the community so that the elderlies can actually, of course, pay money, but pay, I think, a little amount of money for their daily meals.
Because I think that is a kind of wing wing situation for both the some of these restaurants and also even some hotels near these community.
They can go to these places and have fun. maybe meals lunch and dinner not only that um jd's involved uh their platform the seven fresh kitchen we talked about that their cell phone brand um restaurant yeah healthy options right elderly residents can order meals on its online platform um there and then deliver directly to their homes So they can get healthy food options straight to their front door, which is really good as well.
These are all positive changes.
And it sounds like the industry as a whole is becoming, is tighter the right word?
Upgraded might be the right word, where it's more about having people in place that are qualified certificate-wise to be there.
Programs are being put in place to encourage younger people to become involved as well.
And on the other end of the spectrum, for the elderly, which is the whole point, it sounds as well like everything will become more convenient, which is a great thing.
Are you living in an elderly care center, by the way?
I am not, but I am living in a community with a huge population of elderly.
So I think I really enjoy seeing them, you know, because there is a little square.
Like a dancing square?
No.
It's kind of an activity square you can see in front of the building.
And you can always, because the time that we off shift is the time that kids will get out of their school.
And then the grandparents and the children, they're off.
And you.
And hopefully I can join them.
Not yet.
I'm probably just too tired to join them.
You've got a long way to go, my friend.
A long way indeed.
