On the surface, the Government’s ‘Building a National Care Service’(1) White Paper is good news for assistive technology and telecare.
The White Paper argues that a: “A greater emphasis on preventative services, and the use of assistive technology, can give greater peace of mind for those providing care… Many people may also want to take advantage of the benefits offered by assistive technology.”
‘Building a National Care Service’ also highlights the Department of Health’s current Whole System Demonstrator Project, noting that: “The Department of Health is currently managing a two-year evaluation of the use of telecare and telehealth – with over 6,000 participants, it is the largest randomised control trial of telecare and telehealth technologies in the world, and is expected to report in early 2011.”
And it goes on to say that: “It is safe to imagine that the pace of technological change that we have seen over the last 20 years will continue, and that by 2030 the kinds of technology that will be available to us will be far beyond anything we know at the moment. Those using the care and support system will increasingly expect technology to play a part in helping them decide what care to choose and helping to improve their quality of life, and the care and support sector will need to be positioned to take advantage of these innovations.”
So on the surface, the future for technology in care looks bright.
But on the other hand, this isn’t the first time we’ve seen Government talking technology up. The ‘Independence, Well-being and Choice White’ paper (2) in 2005 made similar points about the potential of telecare as did both the National Stroke Strategy and National Dementia Strategy.
And although Government has invested in pilots and the Whole System Demonstrator, there can be no denying that the spend on many of these technologies remains relatively small. The projected telecare spend in 2009/2010 (by social care authorities) is under £80million and represents a tiny proportion of total care spend (3). This is despite the growing evidence of its long term cost-effectiveness.
If technology is to achieve its potential we need a focused policy review on why progress has been so slow. We must ensure a real public and political debate on the ethical and practical opportunities and challenges which emerge from new technologies. We must also explore how to ensure these technologies can go beyond monitoring to tackling isolation and delivering an improved quality of life for all older people. We must address ageism in design (4), and work to remove commissioning barriers whilst also finding a way for the health and care service to jointly fund new technologies. And we must find ways of advising or indeed convincing the older person to buy some of these products privately, or with their personal budgets.
In the White Paper, the Government has expressed a positive vision for technology and care. But both the end consumer and the market are going to need support if this vision is to become a reality. There are emotional, financial, legal, policy, and practical barriers to more widespread use of technology in care. One of the first priorities for the National Care Service must be to understand how these barriers can be broken down.
David Sinclair
References
1) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4106477
2) http://www.dh.gov.uk/en/MediaCentre/Pressreleasesarchive/DH_114951
3) http://www.dhcarenetworks.org.uk/_library/Resources/Telecare/Telecare_advice/Newsletter/Telecare_LIN_eNewsletter_Oct_2009.pdf
4) Simon Roberts, The Fictions, Facts and Future of Older People and Technology, ILC-UK http://www.ilcuk.org.uk/record.jsp?type=publication&ID=54