Older People: Their Place and Contribution in Society

Lord Crisp Excerpts

Friday 14th December 2012 Lords Chamber

[Lord Crisp]

My Lords, I, too, congratulate the most reverend Primate on his welcome, timely, wide-ranging and clear speech. I want to echo one particular point on the importance of public policy being geared towards maintaining dignity and capacity. This is really a definition of what I think of as healthy ageing. I am very glad to know that old age does not start until 62. In the light of the ageing population, I would like it confirmed that it will be going up one year for every year from now on. The figures are extraordinary. Our life expectancy has gone up by 30 years in the past century—that is three years a decade or about eight hours a day. It is a remarkable change that we are going through and that is why healthy ageing is so important.

I want to say three things. The first two are very positive and celebratory; the third is not, but together they are important and can contribute to a healthily ageing society. I am going to use health examples but they have wider relevance.

First, I learnt something very interesting about decision-making when I was a hospital chief executive. I used to attend ward rounds, which concern decision-making about individual patients. It is interesting to look at the dynamic. There is the contribution of the patients and their families and the contribution of the nurses. However, when you turn to the doctors you see the hierarchy in action. The students and the SHOs—the younger people—set out their ideas, which may sometimes be wildly off the mark. Then there are the registrars. In the days when I was chief executive, the senior registrar would be the person who knew absolutely the latest evidence on everything, drew their own conclusion and set it out for others. It almost always rested there. However, in about one in every 10 cases the consultant came in, perhaps because they had seen some pattern or recognised something that they may have seen 15 years previously. They provided another insight about not the latest research but history and knowledge. Perhaps in some ways it was about pattern recognition; occasionally, it was even about wisdom.

I learnt then what an excellent pattern of decision-making that is and what a good metaphor it is. We need the three sorts of knowledge and the different perspectives: the questing hungry sort of the young people, the central authoritative sort of the up-to-date people in the centre of their lives, and the different perspective of the experienced older people who have seen a lot. We need all those perspectives and we need to honour them all. We can too often miss out some parts of that collection.

Secondly, there is the valuable role that older people can play, as has been mentioned by many noble Lords. The noble Baroness, Lady Bottomley, talked about B&Q setting up a store with older people and the noble and learned Baroness, Lady Scotland, talked about BMW in Germany. I want to give a health example called Grand-Aides, a name which is drawn from grandparents. It is an American idea but it is now getting global impact in a number of countries. Very simply, it is about involving older people in the healthcare team, sometimes part-time, with them coming in—properly trained, of course—at the healthcare assistant level. They have a unique capacity to contribute. As we know, work contributes enormously to people’s self-worth and to the dignity that the most reverend Primate spoke about. Older people also have the time and experience. Sometimes they can understand the little clues in the patterns of people’s lives that maybe other people cannot.

I also note from the House of Lords briefing that, in our own country, the people who retire earliest are very often in healthcare, which is interesting when it is in healthcare that we are going to see more need, over time, for more time to be spent with people. The real scarcity is going to be in the time of professional staff; it is not just about money. There are lots of other examples where people can contribute but the health one could be important.

Alongside all this potential and my previous two points, there is the sadness of what so often happens in reality. Other noble Lords have talked about poverty and disability, both physical and mental. I want to touch on loneliness and isolation, something that the noble Lord, Lord Glasman, just talked about. The number of people who live alone is terrifying and astonishingly large. It can be debilitating, destroying and numbing and is linked to ill-health and poor survival rates. I am reminded of Dr Doug Eby, from the Southcentral Foundation in Alaska, who says that with older people in particular, as with most of us, the primary diagnosis is social. You may be treating an elderly man for Parkinson’s disease, for example, but the fact that he may be isolated, not eating, not warm or not washing properly are the issues that have to be addressed and which are seen so often in our health service. We know that this isolation has an appalling impact on health and survival.

Other noble Lords have not yet mentioned some of the research on healthy ageing. It has been talked about in an instinctive way—about people wanting a meaningful existence, for example. However, the research from Japan, America and elsewhere shows that three things are the key to healthy ageing. First, there is getting into your 60s while healthy; secondly, there is having some meaning in your life, with something to do and the ability to contribute; and thirdly, there is having some kind of social life. All the evidence shows that those three things, coming together, contribute to healthy ageing. It reminds me again how privileged I and all noble Lords are to be in this best club in town with access to all three things.

In public policy, we need to explore much further the dynamic of healthy ageing. We need to understand healthy ageing and bring the three parts of my argument together: using the wisdom of older people—or shall we call it experience?—developing ways of bringing people into careers, and getting into caring and combating isolation.

In doing so, we also need to recognise the equity gap, an issue which has been so clearly raised by at least three noble Lords who have spoken. There is the gap concerning people from minority ethnic communities in this country, raised by the noble Lord, Lord Dholakia; the gap in equity itself, raised by the noble and learned Baroness, Lady Scotland; and the differences in healthy life, raised by the noble Baroness, Lady Greengross, who referred to 45 years of healthy life in the north of the country and 51 years of healthy life in the south. There is enough evidence here for us to start to create a sensible public policy about healthy ageing and bring together the research about getting into your 60s while being healthy, having a meaningful existence and having a social life.

This brings to me my last point, which is that this is also about political will, politics and power. I am agnostic on the need for a Minister for older people—or, indeed, a commissioner—but I was interested when an MP friend of mine told me the other day that, until very recently, older people were not of great interest politically because it was assumed that by the time you got into your 60s your political views were settled and, therefore, that you were going to be on one side or the other. However, she told me that that is now changing. It would be interesting to hear the views on this of the noble Lords on the Front Benches who will be summing up the debate: on how they see the future, how much they recognise the power of the grey vote and whether they see this having significant implications for policy in the future.