Perhaps, like me, your Christmas break was dominated by debates with family and friends about Brexit. For everyone in government, not least the Prime Minister, it must have been difficult to think about anything else while chewing on their turkey.
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.
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, along with the Long-Term Plan for the NHS. Part of the reason for creating NHS England was to remove the NHS from politics so these delays are disappointing. Securing a sustainable long-term settlement for the NHS and allowing local NHS organisations the time to develop local plans is vital if the NHS is to move away from short termism and stumbling from one winter crisis to the next.
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.
The truth is that we must think and do things differently across almost every aspect of our society if we are to add quality of life to those extra years. The pace at which much-needed policies are being delivered by the Government machine simply isn’t fast enough. Delaying action until after 29 March is not an option. The world keeps on turning, our population continues to age, and things won’t wait for us to finish our negotiations with Europe. We must act now.
Dr Anna Dixon is Chief Executive of the Centre for Ageing Better