The Health and Social Care Bill has its second reading – a debate on the general principles of the Bill – in the House of Lords on Tuesday 11th and Wednesday 12thOctober. More than 90 Members of the Lords have put their names down to take part in the two-day debate. Two Peers have tabled amendments to try and force extra scrutiny of the Bill because of concerns that the Bill was rushed through the House of Commons. Labour peer Lord Rea, a former lecturer at St.Thomas’ Hospital Medical School and GP, has tabled a motion that, if passed, would mean the Bill would go no further in the House of Lords and could not pass into law in this session of Parliament. Lord Owen, a Crossbench peer, physician and former Parliamentary Under-Secretary for Health, has tabled a motion that would have the effect of sending certain clauses of the Bill to a select committee. In particular Lord Owen wants to see extra examination of changes the Bill makes to control of the NHS, the role of the secretary of state and the plans for Monitor, the new NHS regulator.
The Bill, which has completed its progress in the House of Commons, aims to change how NHS care is commissioned through the greater involvement of clinicians and a new NHS Commissioning Board; to improve accountability and the involvement of patients in their care and to give NHS providers new freedoms to improve quality of care.
Age UK wants to see the Bill act as a catalyst to improve health services for older people. Throughout our work with parliamentarians during the course of this bill we have been pointing out the problems older people face in accessing health and social care services. Too many older people in the UK experience poor practice and ageist attitudes when it comes to care which can put their health at risk. Older people often struggle to access the basic care they need as the NHS continues to under-commission essential preventative services such as falls prevention, continence care and audiology. These types of services make a huge contribution to keeping older people well, independent in their own homes and helping to maintain a decent quality of life.
NHS reforms will impact on everyone to a greater or lesser extent but they are likely to be most keenly felt by older people; patients over 65 account for around 60% of admissions and 70% of bed days in NHS hospitals. Our ageing population means it is more and more important for the NHS to meet the needs of older people. We want the new NHS commissioning board to instigate a fundamental review of how the NHS and local authorities assess, prioritise and commission services to meet the needs of an ageing population to make sure NHS structures, particularly the new commissioning bodies understand and know how to meet the needs of older people across the UK.
Read our Health and Social Care Bill briefing
Sometimes in life it’s really important to take a step back and make sure we appreciate the good news stories as well as highlight where things have gone wrong. With that in mind, reports this week of a 100-year-old woman successfully beating breast cancer after undergoing surgery is definitely something to celebrate.
The cause for celebration is not just that Mrs Affleck is recovering well after her operation (a wonderful outcome and we wish her very well indeed) it’s that her medical team seem to have done everything right. This might seem a very obvious and somewhat patronising statement on the face of it. What else would we expect from a professional medical team? But equally, given what we know about age discrimination in treatment and care, I think it does warrant a moment to reflect. Not every story has such a happy outcome.
Stories of age discrimination in health care are unfortunately all too common. Cancer care in particular has come in for serious criticism in the past few years. As data sets have improved, meaning we know more and more about people diagnosed and treated for cancer, it has become increasingly apparent that older people are losing out.
Recent evidence suggests that cancers are more likely to be diagnosed late and patients are less likely to be offered a full range of treatment. Admittedly more work is needed to fully understand why this happens, but age appears to be the overriding factor.
Clinicians are making assumptions about medical health based on preconceptions about age rather than actual health status. Indeed in her statement Mrs Affleck points out that she was left frightened by the prospect of a painful death as she’d been told no one would operate on someone her age.
Luckily in this case her surgeon decided to take another view, assessing her as being in good enough health and, even more importantly, taking into account Mrs Affleck’s own views about what was right for her.
There are all sorts of things to take into account when deciding on the right course of treatment, including someone’s general health and fitness, the impact it might have on other conditions and medications and people’s own preferences and choices. However the number of candles on the person’s last birthday cake is not one of them.
Full statements by Mrs Affleck and her surgeon are available on the BBC website: http://www.bbc.co.uk/news/uk-england-manchester-14732945
This guest post has been written by Amy Charters, Age UK’s Health Development Officer.
Sadly, it’s true that falling is a natural part of ageing. Around 30% of people over 65 and 50% of over-80s will fall each year, often with devastating consequences.
After a fall, an older person has a 50% probability of having their mobility seriously impaired and a 10% probability of dying within a year.
The emotional effects can be equally disturbing. Loss of confidence can lead to social isolation, with around 78,000 afraid to leave the house due to a fear of falling.
With the number of cases being so high it’s not surprising that the cost incurred by falls is so great: the current bill to the NHS and associated agencies is £1.8 billion a year; a figure which is expected to rise significantly over the coming years due to the UK’s ageing population.
Despite these facts, and the common belief among young and old alike to the contrary, falls are not inevitable. Continue reading “Watch Your Step for Falls Awareness Week 2011”