How do we make prevention real?

 Leslie, 95, and his granddaughter Wendy.

Two weeks ago, despite it being one of the first warm evenings of the year, a sizeable crowd gathered for the most recent in our series of Tavistock Square Debates tackling the big issues across health and care for older people.  And this debate posed one of the toughest questions yet: “How do we make prevention real?”

Whether we are talking about preventing ill health in the first place or helping people stay well and manage a condition, we all agree prevention is better than cure. Likewise there is little argument that we should aim to prevent a crisis wherever possible.

However, in practice the case for investment and shifting resources ‘upstream’ is not always easy to make. In the light of the renewed emphasis on preventive approaches set out in the NHS Forward View and the Care Act, we asked our expert panel their views on what it would really take to break the cycle of short term targets and siloed budgets; to move from words to action.

Continue reading “How do we make prevention real?”

Impacts of ageing for developed economies

In my second blog on the Ditchley Foundation conference on the implications of ageing in developed economies I’ve digested the discussion on the consequences of ageing. (Read the first post here)

Healthcare

It was striking that the conversation was dominated by healthcare. We distinguished between ‘true’ age-related healthcare costs, associated with chronic conditions and long term care, as opposed to the costs of the last year of life, which arise whenever someone dies and may actually be higher for early death (when people are more likely to benefit from costly interventions).

There was agreement that ageing is not the main driver of health costs, with improving technology and rising expectations considerably more important.

Participants questioned whether US health spending was an unusual outlier, or the inevitable trajectory for other advanced economies. While American delegates tended to be fatalistic about health costs, participants from other countries pointed to their success in checking rising costs and maintaining health spending at a lower share of GDP (usually with better health outcomes, since healthcare only has a small impact on a society’s health). Continue reading “Impacts of ageing for developed economies”

Age UK Budget reaction

Some weeks ago Age UK submitted evidence to the Treasury ahead of the Budget, outlining our key Budget priorities for later life. While we’ve had some good news today, the Chancellor’s response – or silence – in other areas left our ‘wish list’ largely unfulfilled.

The highlight today for Age UK was the hint that the Government will introduce a simple flat-rate state pension of around £140 a week. This will be great news for those who receive it – we’ve been calling for a simpler, better single State Pension for many years. But as always, the devil is in the detail. We didn’t hear today when this pension is going to be implemented, and we know from the Chancellor’s statement that it won’t apply to those currently in receipt of State Pension. With 1.8 million older people living in poverty in the UK today, we believe that more needs to be done to tackle pensioner poverty now.

Future increases to the State Pension Age past 66 will now to be determined by an automatic process, according to today’s Budget statement. While we accept that the State Pension Age will have to increase periodically to take account of welcome increases in life expectancy, simplistic indexation is not the answer. In particular, it’s essential that any increase isn’t based solely on average life expectancy, as health inequalities mean that life expectancy varies wildly across the UK. Any new uprating must also take into account the impact changes will have on the poorest, those out of work and those with health problems or disabilities.

After spending years campaigning for an end to age discrimination, it was disheartening today to see the postponement of new age equality provisions for small businesses. We’ve been promised that this will not include the ending of the Default Retirement Age, which will begin to be phased out from April, but it will water down the banning of age discrimination in the provision of goods and services. Age equality makes economic sense, and older consumers’ spending will be key in reducing the deficit, so we would have liked to see more Government support to help small businesses adapt to the changes, rather than abandoning them.

Finally, there were areas where the Budget said nothing, where action was urgently needed. We already know that adult social care is going to be badly hit from April, as we hear news of local government cuts. We asked the Chancellor to channel any extra money he could find to top up support for care users who are among the most dependent in society. Yet while there was a little extra for other favoured projects – money for councils to fill potholes among them – there was nothing to see off the looming crisis in care.

Read more coverage of the Budget on the main Age UK site

Agenda for Later Life report – 12 challenges

This coming Tuesday Age UK launches our annual policy report, Agenda for Later Life 2011. The full report runs to 80 pages, but over the coming week or so, we’ll be highlighting some of the key points in a series of blog posts. The report opens with a digest of 2010 and a look forward to 2011, which will be mirrored at the Agenda for Later Life conference in the presentation of Tom Wright, Age UK’s chief executive.

We begin by celebrating the good news on public policy in 2010, thanks to the endeavours of both the incoming and outgoing administrations: sweeping age discrimination legislation, the indexation of pensions to earnings, the end of forced retirement; and cross-party commitment to radical reform of care and support. But we also predict that the prospects look much more bleak for 2011. The Spending Review announced spending cuts on an unprecedented scale. Now we have the early announcements on local cuts, we can see that vulnerable older people could suffer badly. The reality is that the genuine efforts the Government made to protect people in later life – by ring-fencing NHS spending, preserving universal benefits, and limiting the scale of social care cuts – just will not be enough to prevent hardship, especially as economic growth appears to be uncertain.

Taking a longer view, Age UK believes the scale of our national response to ageing still feels inadequate, for all the important political commitments of the last few years. There is no sustained, co-ordinated effort to address the scandal of persistent poverty that is designed into our pension system; to tackle hidden isolation and loneliness in our communities; to challenge disrespect and discrimination that erodes opportunity; or to re-focus an NHS that still does not see later life as its ‘core business’.

Age UK has long argued that the nation needs sustained joined-up leadership to help prepare for our ageing society. Despite all the recent commitments, no one is joining the dots or thinking long term. In 2011 we will work to put pressure on politicians on all sides to see this change. We hope that root and branch reviews of care funding and the state pension could open the the way to a wider cross-government programme on ageing. The alternative – in the context of spending cuts, localism and the log-jam of implementation – would be retreat from strategic planning for our ageing nation, with each new challenge written off as ‘too difficult’. Continue reading “Agenda for Later Life report – 12 challenges”

The health and deprivation triple whammy: poor, nasty and short

When in 1651 Thomas Hobbes speculated that life could be solitary, poor, nasty, brutish, and short he certainly did not have in mind the many people over 65 living in poverty in 2011. However, if we said that their lives are poor, nasty and short we would not be far off the mark –according to a study by the Office for National Statistics (ONS).

A recent paper by the ONS looks at inequalities in disability-free life expectancy (DLFE) by area deprivation. DFLE is the number of years an individual is expected to live without a limiting chronic illness or disability. For the UK as a whole, DFLE at age 65 stands at 10.1 years for males and 10.6 years for females. Since 2003, it has virtually stalled both for men and women. Looking across the UK constituent countries, we notice that there have been some improvements in Wales whereas in Scotland and Northern Ireland, men have seen their DFLE reduce since 2004. Continue reading “The health and deprivation triple whammy: poor, nasty and short”