In this the first of my blogs for 2019. I must apologise for returning to that thorny subject of Brexit which has taken up so much political time in 2018 to the detriment of everything else. Spare a thought not least for those who continue to live their lives without the care services they need, who are at the behest of politicians who have failed and reneged on their promise to publish the Green Paper on Social Care.
In addition, the delay has seen the decline in the social care industry, with increasing care home closures and fewer home care startups because of the uncertainty within social care which continues to be in limbo.
It’s right that ministers and officials focus on what is arguably the biggest upheaval in British politics since the Second World War. But with the internal mechanisms of Westminster and Whitehall snarled up by the huge task of negotiating our future relationship with the European Union, we risk losing sight of the many other issues which could have life-changing consequences for an entire generation.
According to Dr Anna Dixon is Chief Executive of the Centre for Ageing Better, near the top of this list, alongside climate change, must surely be how we respond to the seismic demographic change we’re experiencing. We are on average living 10 years longer than our parents’ generation and nearly two decades longer than our grandparents’ generation. In just 15 years, the UK will have 1.2million more people aged 85 and over than it does today – an increase of nearly 70% in this age group alone. Like Brexit, our longer lives will have colossal implications for everyone in our society.
Two of the most pressing challenges are health and care. We have waited over a year for the Government’s long promised Social Care Green Paper for it only to disappear amidst the recent Brexit blizzard. The Long-Term Plan for the NHS has recently been published, but we continue to wait for the Green Paper.
Simon Stevens made clear when he launched the NHS 5 Year Forward View – his first attempt at a strategy for the NHS – that success depended on the government meeting two further tests. Firstly secure funding for social care and secondly maintaining investment in public health. Neither of which have been met. Local authority funding cuts mean social care services have been stripped back to the bare minimum in most areas. For families struggling to fill the care gap, the NHS is the last resort in a crisis when their elderly relatives become too ill, frail or confused to manage at home.
But even if the health and care services receive increased funding to put them back on a more stable footing and transformation in service provision happens, the huge increase in the numbers of people living to very old ages means this will not be enough.
While, many people enjoy their longer lives, with wellbeing and happiness rising throughout people’s 60s and 70s, longer life also means more years managing disability and illness. At 65 men can expect to live a further 18 and half years of which about half is with some disability, while women can expect to live a further 21 years with 11 of those with disability. But disease and decline in old age is not inevitable. We can do better.
In 2019, we need to focus on prevention, stopping people from developing the long-term conditions and preventable disabilities which can reduce their quality of life. Many of the diseases experienced in old age have common risk factors. We need bold action to tackle the biggest drivers of poor health in later life – smoking, poor diet, excess alcohol and lack of exercise.
It is right that Matt Hancock, Secretary of State for Health and Social Care, has made prevention his priority. The recently announced Prevention Green Paper needs to make promoting healthy ageing a key part of its focus and propose evidence-based interventions such as regulation and incentives, as well as changes to the environment, that are more effective at changing behaviour than education. Beyond government, it will need employers, communities, businesses and service providers to play their part in enabling us to age well. For example, designing communities to be more walkable, with decent and affordable transport links, and green spaces that we can all enjoy.
To reduce pressure on our social care services, we must improve the environments in which people live so that people can remain independent for longer. Addressing the inexcusable lack of age-friendly and accessible housing in Britain means a commitment to building new homes that are accessible for people of all ages and abilities. It requires developing more affordable and attractive products to adapt the home and ensuring that people who need aids and adaptations get timely and personalised access.
No one can deny the importance of Brexit which tantamount to the biggest upheaval in British politics since the second world war. But the truth is governments of either persuasion fail to keep pace the speed of social change. Our population continues to age and if we are to take action to ensure a reasonable quality of life in later years for the many then we need action now.
Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy