Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Baroness Watkins of Tavistock Excerpts

Wednesday 20th October 2021 Grand Committee

[Baroness Watkins of Tavistock (CB)]

My Lords, it is an honour to follow the noble Lord, Lord Crisp, and a pleasure to speak in this debate on the report of the committee chaired by the noble Lord, Lord Patel, who has been my mentor since I entered this House and encouraged me to speak today. He introduced this debate so effectively and outlined the challenges that face society in relation to ageing.

Many noble Lords have developed and will continue to develop the important themes of science and technology research investment as an essential building block in developing treatments, AI and robotics to assist people in older age and to target specific illnesses through effective new drugs. I intend to discuss the challenges and opportunities outlined from social care and a “happiness and health” perspective in later life.

The report notes that the proportion of the UK population that is older than 80 is expected to increase from 4.9%, or 3.3 million people, in 2018 to 10%, or 7.6 million people, by 2065. The Chief Medical Officer for England, Professor Chris Whitty, explained to the committee that it is anticipated that older age groups will be

“highly concentrated … in places where delivery”

of care and health services

“is more difficult than it is in cities.”

I recently attended a lecture that he gave at the University of Plymouth. He outlined the particular challenges of reaching people in rural communities and seaside towns, where many young people leave for work but return to retire, leaving a very small young workforce pool to provide paid care work to support older people.

This morning, the current challenges of providing enough care workers to support people as they come out of hospital were made clear by several speakers on the “Today” programme, including Vic Rayner, chief executive of the National Care Forum. There is insufficient modern accommodation, particularly in the social housing sector, to provide supportive living in a cost-effective manner to older people. Yet there is huge opportunity to build units with appropriate technology to enable more independent living, even for people who have multiple morbidities.

I am amazed that it is now possible to wear a watch with a tracking device that records a person’s whereabouts and, if their routine changes, enables alerts to a central hub and/or a named relative or carer within seconds. As a district nurse in the 1970s, I had to return to base to phone a patient I was worried about. If they did not answer, I had to go back to see them. Think of the difference for district nurses today because of mobile phones and modern technology. In addition, Housing 21 and Bath University work to link innovative engineering to do what appear to many to be simple interventions, such as a kettle that can never boil dry, due to a switch-off mechanism, or baths and showers that control the water temperature so that people cannot scold themselves when bathing. People can therefore stay independent.

Can the Minister please explain how the Government intend to promote investment in social housing that will meet the needs of the most deprived older people, so that they can live healthier, more independent lives? The boom of such housing available to those who can afford to buy age-specific homes of this kind illustrates that many older people enjoy living in such communities and are often less lonely as a result. Will the Government also invest in research designed to identify the potential benefits of such interventions on a longitudinal basis to provide data to inform future investments for older people?

I turn from housing as a key social determinant of health to the NHS and social care. Loneliness is a risk factor for both physical and mental health, as is adequately detailed in paragraph 34 of the report. What role should the NHS and care services play, possibly through social prescribing, to reduce extreme loneliness in old age? In the village where I live, the local post office and shop have just closed and, other than school transport, the bus operates twice a day—that is, two buses one way and two back, without a timetable focused on getting people to and from work. There is no bus that enables a 10 am departure and a return before 4 pm, so that someone of 70 years old can use their pass to go to the nearest town to shop, visit the library and perhaps have coffee. These are real issues for people, yet here in London I can pretty well go anywhere anytime. Could further investment in transport from central and local government overcome these issues and thus promote the health of older people?

Can the Minister explain whether Health Education England is exploring the need for specialist health and social care workers to work with older people? There are few Admiral nurses to support people with dementia, yet this is the highest cause of death in women and the second-highest cause of death in men in England, as illustrated by table 1 in the report. The report also highlights the need for more regular medication reviews for people as they get older and the fact that Age UK reported to the committee that

“care packages can only focus on the essentials such as meals and toileting, without any time for help with mobility”.

That is a damning indictment of our individualised care interventions. The noble Lord, Lord Kakkar, outlined the need to provide co-ordinated, compassionate care. It is essential at the moment, let alone in the next 20 years.

Promoting independence is vital if people are to live longer, healthier, happier lives in old age. I suggest that the recommendation outlined in paragraph 275 of the report—

“that the Government clearly defines the roles and responsibilities for healthy ageing among national and local government and their agencies”—

is as essential as blue-skies research. The report clearly outlines the differences in life expectancy between different socioeconomic and ethnic groups. Why is my life expectancy estimated to be nine years longer than that of someone living nine miles away from where I reside, in the most deprived ward of Plymouth?

Finally, can the Minister comment on whether the ageing society grand challenge needs revision, or is to be completely reviewed from the current term, to ensure

“that people can enjoy at least five extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest”

and enable all older people to have high-quality support and care in the last five years of their lives, as necessary, to reduce loneliness and thus promote health and happiness irrespective of income? The new social care levy could, I argue, be used in part to achieve this aim.