International Longevity Centre - UK

The Audit Commission has published a report entitled “Under Pressure” which looks at the way local authorities are preparing to adapt to an increasingly ageing population. The report reveals that most local authorities are failing to prepare services for an increased number of older users and the majority do not know the future financial impact that demographic change will bring. Given looming cuts in public spending, councils clearly need to do more to avoid serious problems in the future. 

Just over half the local authorities examined by the Audit Commission had any reference to demographic change in their financial plans and only one in ten had tried to calculate the potential financial impact of an ageing population on service provision and budgets. Even those authorities who had made some attempt to factor ageing into their planning had focused almost exclusively on social services and transport and not taken services such as housing and leisure into consideration. 

The report suggests that the biggest financial impact of an ageing population is likely to be social care spending, which already increased by 46% between 2000-2001 and 2007-2008. The Audit Commission recommends that local authorities invest in early intervention and prevention measures that can reduce demand or delay social care, mainly by supporting people to stay in their own homes, which is far less costly than residential care. Measures here should tackle problems such as housing, health, social isolation and informal care breakdown, all of which can increase demand for social care. 

In addition, local authorities can take advantage of technology, for example the use of telephone helplines, to provide better services and save money. The Audit Commission also advises authorities to work with older people and relevant partners to get vital on the ground input to help them better plan and deliver services that meet the needs of older residents.

Rebecca Taylor

Baroness Greengross has written for ePolitix.com ahead of her question on the extension of the job guarantees available to young unemployed people to those aged over 50.

Although I believe the government has rightly concentrated its efforts on the young, we are approaching the tipping point of claimants entering long-term unemployment, and should ensure that the economy doesn’t lose out on the skills and experience of an older generation. That is why I am calling on government to extend the job guarantee, currently available for unemployed 18-24 year-olds who have been in receipt of Jobseeker’s Allowance (JSA) for nine months, to claimants aged 50+.

For many older workers a premature exit from the job market will effectively force them into early retirement, as employers are reluctant to take them on for what they see as a short period before retirement, but can easily be for five or ten years – longer than many younger employees will remain in one job.

A recent CIPD report, Our Employee Outlook, Autumn 2009, showed that nearly three-quarters of over-55s need to work past the state pension age as the recession hits their pension. There is a worry that older people, although more likely to keep their jobs in the downturn, are finding it harder to get jobs if they do end up unemployed, and thus may drift into long-term joblessness.

Unfortunately this concern has now been vindicated by recent ONS statistics which show that the number of over-50s who have been unemployed for six to twelve months increased by 136 per cent in the year to October 2009, around double the rate of increase for young people. Furthermore, one in three unemployed over-50s have been unemployed for more than 12 months, which is the highest percentage of all of the age groups and higher than the overall average (25 per cent).

Six months is clearly a tipping point when people need to move back into the labour market or risk remaining unemployed for 12 months or more, and the government’s move to reduce the qualifying period for the job guarantee from 12 months to 6 months shows that this is a critical juncture for unemployed people.

If the 100,000 older workers who have been unemployed for 6-12 months are not helped back into work in the coming months, they will be more likely to remain on benefits until retirement. With large numbers of older workers in this unemployment bracket, I am very concerned that long-term unemployment will condemn many people to an uncomfortable retirement and force them to rely on state benefits – an additional burden on the wider economy as well as a blow to their self-esteem and sense of worth.

This article was published on 22nd February at http://www.epolitix.com/latestnews/article-detail/newsarticle/government-should-extend-job-guarantees-to-over-50s/

The Labour government came to power aiming to tackle health inequalities and committed itself in 2003 to reducing inequalities by 10% by 2010, (measured by infant mortality and life expectancy at birth). While overall life expectancy has increased, the health gap between the rich and the poor has actually increased according to “Fair Society, Healthy Lives”, a strategic review of health inequalities in England, published earlier this month. 

The review, which was led by Professor Sir Michael Marmot, says that reducing health inequalities is not only a matter of fairness and social justice, but is also vital for the economy. The cost of health inequalities leads not only to additional strain on NHS resources, but also results in lost productivity, lower tax revenues and higher benefit payments. 

Highlighted is what the review calls “the social gradient in health” - a strong correlation between health status and social circumstances such as level of education, occupation, employment status, and housing conditions. This social gradient does not just affect life expectancy, which results in an average difference of 7 years between the poorest and richest in society, but also affects disability free life expectancy, which is the number of years a person can expect to be in good health. The review reveals that people living in the poorest neighbourhoods in England can expect 17 fewer years of good health than their wealthy counterparts. 

The health inequalities arising from this social gradient cannot be satisfactorily explained by lifestyle or problems in accessing healthcare services. The review therefore recommends that health inequalities are tackled by action on a number of non health-related fronts such as early years education, employment and skills, tax and benefits, public transport, green spaces and energy efficient housing. 

The report also backs the idea of establishing a “Minimum Income for Healthy Living” (MIHL), which would provide people with the income needed for proper housing, good nutrition, transport, healthcare and physical activity. 

Despite government initiatives such as Sure Start, tax credits and pension credits having made some progress in reducing health inequalities, there is still room for significant further improvement. Any action taken needs to be across society, not just aimed at the most needy, and will requires a life course response beginning with early years initiatives and continuing through to retirement. 

The Marmot report also highlights potential fairness issues for future governments which are likely to be minded to increase the state pension age to 68 or beyond. If, as the review suggests, 75% of the population will not be in good enough health to work until that age, further action will be required to ensure that reducing social inequalities in later life. To enable people to work longer, for example, more comprehensive preventative healthcare services for the over 50s will be necessary. 

Rebecca Taylor 

David Sinclair

http://www.ucl.ac.uk/gheg/marmotreview  

Gordon Brown has this week pledged to introduce a personalised approach to social care. Dubbed the National Care Service, it could see 350,000[1] of the nation’s elderly gain greater control over how and where they are cared for. The scheme would allow the most frail or in-need to be looked after in their own homes for free. “Too good to be true”, I hear you cry. But what may seem an ambitious plan makes a lot of sense, both for the older population and the public purse.

Many of the UK’s elderly reluctantly go into care homes when they would rather stay at home. Despite the standard of care being much higher here than elsewhere in Europe, for some, it’s a matter of independence, dignity and the social ties with neighbours, family and friends.
What made a scheme of this kind unrealistic in the past is the cost of managing older people’s health needs remotely. The outcome of a lapse in care can have an expensive impact on hospital admissions and individuals’ long-term health. And with elderly patients taking an average of five prescriptions each[2], managing medication at home can create a further burden on the public budget. Whether patients don’t take medication as prescribed, or it doesn’t have the desired effect, it equates to pouring a significant portion of the NHS’ multi-billion pound drug budget down the drain. In the financial battle between care homes and home care, the residential option has traditionally come out on top.

So the question remains: how to afford the unaffordable. How to trim the cost of caring for our elderly in their own homes. Organisation is the answer. The technology and resources now exist to make this an affordable alternative to the much-travelled route from own home to care home.
Inventions like e-health and intelligent packaging make it easy for medical professionals to monitor remotely when patients take their medication. Automatic alerts sent from drug packaging to mobile phone to PC, make communication between carer, GP and family more seamless and cost effective. Plus, the expertise of local pharmacists is a largely untapped resource that could make high levels of compliance, care and recovery an achievable prospect.

We’re no longer a nation that trusts its government implicitly to look after us at all stages of life. We’re as discerning about how our share of public funds is spent, as we are our own income. That’s why Gordon Brown’s proposition to give older people more control over their care options is a step in the right direction. A move to closely monitored home care will improve health outcomes and free up space in care homes and hospitals. The savings this generates will help offset the cost of in-home care, making it a feasible and sustainable solution to the elderly’s care conundrum.

Norman Niven, CEO, Protomed