Does England need to do better for its ageing population?

Wales and Scotland have their own strategies and representatives for older people. Is England doing enough, asks Beena Nadeem?

Older lady sits in armchair looking pensive

 

We’re all living longer. Today, excluding the possible impact of coronavirus, one in four babies is expected to reach that magic milestone of 100 (an increase of 73% to 13,170 since 2002) while the number of people reaching 105 has now doubled since 2002. But having survived the great depression, the Second World War, the creation of the NHS and the swinging Sixties, it seems that many older people these days face the final decades of their lives in ill health, loneliness and poverty. That’s unless policy and planning can catch up with a rapidly ageing society.

The way we age

Dr Anna Dixon, Chief Executive of the Centre for Ageing Better, says: “People living in more deprived areas are not only set to live shorter lives, but will spend more of those years in ill health.”

The charity shows these ‘unacceptable’ inequalities are set to continue. The 10 areas where life expectancy is highest (six in London and the rest in the South East) are in Britain’s wealthiest. Here, denizens can expect to live a decent 20 years longer in good health and disability free.

Meanwhile, the recent Marmot Review 2020 shows that women have it worse than men, and with the poorest 10 percent, age expectancy has actually declined.

England drags its feet

England’s approach to its older people has been sporadic. Unlike Wales and Scotland, it has not created a strategy for its older people nor does it have a dedicated minister or older people’s commissioner.

For many years, English policy has lacked any joined-up objectives.

In 2017, it published its Industrial Strategy – the nearest the government has got to a joined-up approach. That identified challenges for an ageing society and committed to five more years of healthy, independent years by 2035 and narrowing the gap between the experience of the richest and poorest. Under this came its Ageing Grand Challenge, which has only very recently been updated for the first time to take a cross-departmental approach to work, health, home and economy in regards to age.

There’s also a number of piecemeal policies, from The Women and Equalities Committee’s inquiry on older people and employment, where no action was taken, through to The Health and Work green paper consultation (published last July) with a final report due. There’s the 2030 Homes competition to design homes for the future, as well as a loneliness strategy and the House of Lords Intergenerational Fairness inquiry published a report and a flexible working consultation along with a few others, but essentially there’s confusion about which department leads on what, leading to stagnation.

Jen Summers, a policy officer at the Centre for Ageing Better, says: “The government must take action to ensure ageing is at the heart of all policies. The Industrial Strategy Ageing Grand Challenge is a great first step, but we need stronger action and a holistic focus rather than piecemeal policy proposals.”

Is England getting better?

On a much more positive note, however, England recently set-up an All-Party Parliamentary Group (APPG) for Longevity. With names like Damian Green behind it, it is likely to make people sit up and take notice, while reiterating commitments to reduce the life expectancy gap between the richest and poorest older people and meet the government’s own target of adding five extra healthy years to lifespans by 2035.

Moreover, some parts of the country are taking a lead. Greater Manchester Combined Authority has been recognised by WHO Global Network for Age-friendly Cities and Communities which firmly sets the region’s status as not only the UK’s first age-friendly city-region, but also a world leader and it is already attracting attention from European counterparts in Barcelona and Amsterdam.

Mayor of Greater Manchester Andy Burnham launched the region’s age-friendly strategy in 2016 and is looking at how the region’s new devolved powers could take forward an age-friendly agenda.

Manchester’s ageing hub

Set up under GMCA, some of the hub’s initiatives include 53 neighbourhood projects along with academic and creative outlets aimed at launching a national centre for ageing and creativity. It’s also working with the UK’s think tank on ageing – the International Longevity Centre UK – which is looking into the opportunities for growth and innovation that ageing populations present and to create new goods and services to benefit this. Meanwhile, focusing on older workers, it has teamed up with the Department for Work and Pensions to provide “opportunities for employment support for older people and promoting age-friendly employers and also promoting apprenticeships for older workers”.

Critical to its success, says head of the hub, Paul McGarry, is the fact that “[the region’s] 10 local authorities are working on their local plans and new programmes on ageing to test out how local services work together to make a difference – especially for those most marginalised”.

Wales

Wales plans to become the ‘best country to grow old in’ and is the first country in the world to have created the role of an Older People’s Commissioner, Heléna Herklots, who, with legal powers, represents and defends the interests of Wales’ older people. Through her department, there has been a Strategy for Older People (running from 2003 to 2023), a Declaration of Rights for Older People and a Ministerial Advisory Group for Older People.

In Wales, the number of people aged 65 and over is expected to rise to over a million by 2033 (26 per cent of the population). Herklots’ own State of the Nation’s report highlights the stark inequalities that exist within the older population in Wales, with increasing inequalities between healthy life expectancy in the least and most deprived areas in Wales (at its widest, 18 years).

Poverty among pensioners is another problem, (a recent Joseph Rowntree Report found one in five people in Wales live in poverty). The commissioner is pushing measures to get the £214 million of Pension Credit (40% are simply unaware they’re entitled to it) that went unclaimed last year into the pockets of pensioners. She has also opposed and reversed the Welsh Government’s proposal to increase the age of eligibility for the concessionary bus pass from 60 to 67 (tying it into the increases in State Pension Age).

Wales has also undertaken the biggest ever review into care homes using new powers of unannounced entry, which resulted in reviews in food, care and training.

One issue that all nations cannot escape is social care funding, and in Wales, austerity measures and demands on Welsh authorities have seen 20% shaved off their funding, leaving 17 councils with a combined overspend of £35m this year to meet social care bills.

Herklots says: “Part of this must include looking at how to support and grow the social care workforce, ensuring that the skills of care workers are properly recognised including through better pay.

“We need a shift in how we view social care, so we recognise it as an essential part of the infrastructure of our society, and give it the attention, funding and status that it deserves. I will continue to do all I can to bring about this change.”

Scotland

Scotland has its own minister for Older People and Ageing, to bring the challenges of ageing to the forefront of Parliament.

But Scotland has a unique set of problems. It has large swathes of rural land with much of its older people living in rural communities. It is also the fastest ageing nation in the UK as well as suffering from its own care crisis, about to be made much worse when it comes to recruiting care workers because of Brexit.

The National Records of Scotland show that health, care and housing needs will all be more in demand by older people with a 23.2% rise in the number of pensioners by 2043 (equivalent to more than 240,000 older people) while only 62% of the population will be of working age.

Age Scotland says around 150, 000 pensioners live in poverty and, although the Scottish Parliament is able to focus on helping resolve the problems with underclaimed Pension Credit, by 2035 there will still be almost 740,000 people aged 75 and over – a 68% increase on 2015’s figure and with it, the length of time people spend in ill health will rise alongside life expectancy.

Like anywhere else, the social gradient in healthy ageing is rooted in inequality and although it has made moves to ensure older people are considered in policy and planning in a joined-up way, Parliament itself admits this takes time.

Dr Elaine Douglas from the University of Stirling is working on healthy ageing as part of HAGIS.

She points out that proposals to extend the retirement age from the current age 65 to 67 by 2028, and to 68 by 2046, need to take account of the Scottish context.

“There’s some desire to work longer, but in the context of Scotland, many would be in manual work and, depending on the nature of their work, working for longer before one can draw a pension is not always attractive.

“There are many issues around supporting people and retraining for jobs,” she says. They include the impact on income tax. “Older people who work tend to be more advanced in their careers and therefore contribute most to the public purse through tax,” says Dr Douglas.

Once again social care provision rears its head. “Here we have free personal care for a while now, but it’s not quite what it sounds,” she adds. “It’s only free care to get washed and into bed, and that’s not adequate help if you need feeding and getting up out of bed.” And with all of this, she says, is the problem of recruiting care workers – the pay isn’t attractive and lots of carers are also older workers.



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