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

Baroness Young of Old Scone Excerpts

Wednesday 20th October 2021 Grand Committee

[Baroness Young of Old Scone (Lab)]

My Lords, when I first came to this House, the doorkeepers told me that this was the best elderly daycare centre in London and that it would give me another 10 years of life expectancy, so this is an apt report for your Lordships’ House. I join my former colleagues on the Science and Technology Committee in thanking the noble Lord, Lord Patel, for his chairmanship of this important inquiry and echo his thanks to the staff, who supported us splendidly.

It is clear that improvements in healthy life expectancy have stalled. On average, about 20% of our lives is spent in poor health. The gap in life expectancy between the rich and the poor has widened even further.

I want to pursue three areas this afternoon. The first is to touch on technological support for older people to help to improve the quality of their lives. The second is to focus on the root causes of increases in years of ill health and disability—the root cause is indubitably poverty and deprivation—and to explore what the Government’s levelling-up agenda must do to tackle them. The third is the importance of integration of action across all policy areas nationally and locally and how the recent changes in responsibilities for prevention of ill health will work out.

I have some lasting impressions of the committee’s work. First, the foundations for healthy old age are laid down from our youth onwards. We need to focus on how people can be healthier throughout their entire life course and not try to put a sticking plaster on the situation once old age is reached. Secondly, there is a pronounced societal difference in healthy life expectancy, which is highly correlated with deprivation and ethnicity. The difference in healthy life expectation between the least and most deprived is nearly 20 years. Poverty and deprivation are the root cause of unhealthy ageing. That is totally unacceptable in a civilised society. However, perhaps my most abiding memory was that we convened a panel of elderly people to help our deliberations only to find that Select Committee members were generally older than the elderly people.

I will raise three issues directly with the Minister. The first is the role of technology in enabling healthier ageing. There are many technologies, such as digitally based products and services such as fall trackers, medication monitors and digital befrienders, and other newer technologies such as robots and digital surveillance programs, all of which could help to support older people, improve their quality of life and allow them to maintain a more independent existence. But provision is low and the poorer and more deprived simply do not get access to such help. That gradient will increase with new technologies becoming more and more available. That has to change. What plans does the Minister have to accelerate not only the pace of technological development but, more importantly, the uptake of those technologies?

Secondly and most importantly, let us not be in any doubt that the root causes of unhealthy ageing are deprivation, unemployment, poor education and housing, lack of opportunity and unhealthy diet and lifestyles, including smoking and alcohol. Tackling these root causes sounds just the thing for the Prime Minister’s levelling-up agenda. Sustained action is needed over a lengthy period, with co-ordinated efforts between national and local government.

Cutting the income of the poorest by removing the £20-a-week universal credit payment does not fit that bill, nor does a spending review and Budget in the next few weeks that has been trailed as the ultimate austerity measure by the Chancellor, who seems increasingly out of love with his boss’s objectives. We are facing another version of the TB-GBs—I will leave your Lordships to fill in whatever acronym you would like for the new Chancellor versus Prime Minister tension. We need not a focus politically on the red wall seats and town centre tart-ups but a sustained attack on inequality and lack of opportunity wherever it occurs.

It is only three years since the Government set themselves the target of five extra years of healthy life by 2035, but that target is already being airbrushed out. Its future is unclear from the Government’s response. Can the Minister confirm whether, in his view, the ageing society grand challenge will survive the proposed review that will be undertaken and whether the five extra years will still be a target? If the target has gone within three years of being established, how confident can the Minister be that the sustained approach required to tackle poverty and deprivation will not be as ephemeral? We no doubt await the White Paper on levelling up later this year, but it would be good to get a feel from the Minister now.

My third point is about the importance of integration of action to promote healthy living across all departments and many policy areas, such as work and education, transport and housing, air quality, local environment quality et cetera. Public Health England, which was responsible for co-ordination on prevention and health promotion, has gone and the Office for Health Improvement and Disparities was launched only at the beginning of this month. I understand that there is to be a cross-government ministerial board on prevention to drive forward a co-ordinated government approach on the wider determinants of health. How often has this ministerial board met and what has it done so far?

The local effort is to be driven by local directors of public health. I will pay a small tribute to those incredibly important people. They are currently up to the neck in Covid and before the pandemic were definitely below the salt for esteem and resources in local authorities. Can the Minister tell the Committee in detail how the Government will ensure that local directors of public health will be given the position, authority and resources to do this co-ordination job across many policy areas on a local level?

We hear much about the pressure on the NHS these days. Much of that pressure is due to those substantial years of poor health that, on average, many people experience. The Government need to see the challenge of healthy ageing as an issue of economics and of health service sustainability, but above all as an issue of equity.