9 June 2004
Malcolm Wicks MP
Minister of State for Pensions
Older Peoples Advisory Group
9 June 2004
(CHECK AGAINST DELIVERY)
A hundred years ago a third of the population was under 16 and people over 50 only made up around 15% of the total. Only one person in a hundred was aged 75 or more.
Centenarians are now the fastest growing population group and by 2021 there will be more people aged over 80 than children under 5.
We should not be viewing longer life expectancy as a problem. Let me read you a quote from Titmuss (and this was written as long ago as 1955):
“Viewed historically, it is difficult to understand why the gradual emergence in Britain of a more balanced age structure should be regarded as “a problem of ageing”...This should be a matter for satisfaction.
Paradoxically we are alarmed by our success. Perversely we speak of the “crippling burden” of old age, forgetting that the extra-ordinary youthful structure of Victorian society entailed a phenomenal rate of growth in numbers and was accompanied by great losses from morbidity and mortality among children and young people.”
At the same time we need to recognise that some older people have special needs which need to be met. We need to improve the way that we do that without making people feel as though they are recipients of assistance and so a burden.
Most of us now can look forward to spending a third of our lives aged 50 and older and for most of this time most of us can expect to enjoy reasonable health.
We need to explode the myth that associates old age with dependency and aspire towards a society where older people are regarded as citizens who have the same access to opportunities and choices as everybody else.
Across Government there has been progress in developing more co-ordinated services for older people – the National Service Framework for Older People and Supporting People initiatives are examples of this.
Government is giving greater weight to the promotion of well being and independence and this is in line with thinking in the academic community and professional organisations – the recent LGA/ADSS publication All Our Tomorrows is an example of this.
We said we would make progress towards joining up services for older people into a coherent “third age” offering. And I think we are getting there. We are building on the Care Direct pilots in the South West.
These have demonstrated that building closer partnership arrangements between central government bodies, local government and the voluntary sector has made it easier for older people to access the range of benefits and services they might be entitled to without having to contact numerous organisations unnecessarily or provide documents or information over and over again.
To support the national roll out of these pilots, we plan to publish an operational document which will be published jointly by DWP, DH, ODPM and LGA in July.
Some local authorities in planning and commissioning services have already gone well beyond making the traditional links between health, social care and housing.
In Liverpool a Framework for Integrated Whole System Working maps the full range of services for older people from Level 1, citizenship and active ageing – for example, leisure and learning, engaging older people in decision making and physical activity – to Level 5, hospital and residential care.
The Framework can be used as a planning tool to change the balance of future services between the levels with the aim to shift resources upstream from Level 5.
We want to promote this “whole systems” approach more widely and my Department is currently working with the Office of the Deputy Prime Minister and the LGA to encourage local authorities to map out coherent strategies for older people.
But at the heart of our strategy for older people is the belief that a person’s later years should be at least as fulfilling as their earlier ones. Most older people will tell you that the factor that affects quality of life most is their health.
So prolonging good health must be an ambition for us all. Health problems do increase with old age and our services must plan for that. However, around half of over 80s say they have no ailments that limit their activities.
We want that proportion to increase in the future. The way we live now will influence our health in old age. People need opportunities to be physically active, encouragement to stop smoking and information about healthier eating.
We have already introduced preventative health measures such as free eyesight tests for people over 60 and free flu jabs for people over 65.
Health choices remain the responsibility of the individual, but support and information are increasingly available to people – for example NHS smoking cessation clinics and the Government’s recent publication of Choosing Health informing people of the benefits of healthy eating and physical activity.
Staying active is not just about keep fit. Learning opportunities should not just be confined to the young. Increasingly people are taking advantage of life-long learning opportunities – last year around a quarter of UK online users were aged 60+.
You may have seen the Prime Minister’s recent announcement that adults returning to education will soon find it much easier to catch up on the qualifications they didn’t gain at school. Under a pilot scheme due to start this Autumn adult learners will be able to take basic qualifications without paying the usual fees.
Social networks are important to us all, but 49% of people aged 75+ live alone – far higher than any other age group. In order to engage in group activities, visit friends and relatives and use services people need transport.
Pensioners now pay no more than half fares to travel on local buses. I know there has been some campaigning to extend this concession and provide a free UK wide public transport for older people. But when we ask older people why they don’t make more use of public transport the main reasons are lack of availability and health.
The Local Transport Planning guidance states that local transport planning needs to be an inclusive process. Local authorities should actively involve and tackle the transport needs of local people including groups representing the interests older people.
So for most of the time, most older people can maintain themselves at home without assistance. But we must be realistic, and as people get older they are more likely to need some form of support. We need to be sure we have in place good quality intensive support packages for people when they need it, wherever they live.
We know that older people are the biggest users of NHS services and we have made the biggest ever investment in the history of the NHS – 7.5% above inflation over the 5 years 2003 – 04 – 2007-08.
The National Service Framework for Older People tackles age discrimination in the health service, raises standards and reduces inconsistencies in the standard of care available UK wide.
New investment in intermediate care is bridging the care gap between hospital discharge and living at home. Above all, our community care policies are based on choice and independence, enabling older citizens to remain at home for as long as possible.
And while I am on the subject of support systems, let me talk about one very important group of people whose valuable contributions have often gone unacknowledged in the past.
One in ten of us are likely to provide informal care to another person in our lifetime. 71% of carers are looking after somebody aged 65 or over in a private household. Often these carers are older people themselves looking after their older parents or adult children with disabilities.
The National Carers Strategy, published in February 1999 includes a range of commitments to give carers better information and better support. In 1999 also we introduced the Carers Grant which has provided an extra £325m over the past five years to increase the number of breaks for carers.
The Carers (Equal Opportunities) Bill received Government support on 31 March 2004. The Bill was considered in Commons Committee on Wednesday 10 March 2004 and all the Government amendments were accepted.
The Bill as it now stands will ensure that councils have a duty to inform carers of their right to an assessment of their needs and consider while undertaking that assessment to consider the carers need or wish to work, participate in training or leisure opportunities.
I hope I have made it clear throughout that I am under no illusion that any part of the system can deliver the requirements of an ageing society alone.
This is all about partnership – a network of service providers, strategic planners, the voluntary sector and local and central Government need to join up to deliver the right services that are focussed on the whole person, rather then based upon administrative convenience.
As I have been around the country I have observed the difference the voluntary sector working with others has made with low-level innovative support schemes for older people.
In Eastleigh a scheme, jointly funded by the local authority, the Primary Care Group and Hampshire County Council social services, with backing from Help the Aged, provides a low cost minor repair service and free home safety advice.
And when we talk about partnership it is vital that older people themselves are involved in planning and service delivery. I think it is true to say that now that community care has been established there is increasing emphasis on user-involvement generally and the potential contribution of older people is increasingly recognised.
But not all older people see themselves as having a role to play in the planning and delivery of services. This may be particularly true of ethnic minority elders, people in rural areas and the frail elderly.
The Better Government for Older People’s network and the Older People’s Advisory Group have shown us the value of encouraging the participation and engagement of older people in the future development and modernisation of both local and national services.
In particular, by encouraging the development of strategies for joined up services at a local level, by bringing older people’s service needs to the attention of service providers and by sharing best practice through its learning network Better Government for Older People and the Older People’s Advisory Group have made a real difference to older people’s lives.
The Government has just invested up to a further £320K in BGOP/OPAG to carry forward this work for another year.
The third age development programme now offers a focal point for OPAG’s role in sensitising local partners to older people’s needs and to work from the inside to achieve change.
I know that OPAG are working as equal partners at the heart of regional and democratic processes in many areas including Sheffield where OPAG has contributed to the development of a new senior safety strategy, and Lancashire where OPAG has influenced a local transport manager to cancel an £6M order for buses which did not meet the needs of older people.
In July last year older people in Worcestershire manned drop off points for people to bring in unwanted medicines. Already there has been a change in prescriptions as people become aware of the extent to which they have been over-ordering. This initiative is now being rolled out with effect elsewhere in the country.
There are lessons to be learnt and already there is plenty of good practice on which to build. Only by continuing to work in partnership, working across boundaries and improving access to services and information can we deliver the services we all expect to have access to as citizens.
What makes OPAG different is its mission to work with the key delivery players to make services more responsive to real needs. That’s the tough way to do things, but also the real way.
The Government appreciates the voluntary efforts of OPAG members. My aim is to drive forward realistic change, to show you that your efforts are not wasted.