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

Lord Patel Excerpts

Wednesday 20th October 2021 Grand Committee

Moved by

[Lord Patel]

That the Grand Committee takes note of the Report from the Science and Technology Committee Ageing: Science, Technology and Healthy Living (1st Report, Session 2019-21, HL Paper 183).

[Lord Patel (CB)]

My Lords, it is a great privilege to open this important debate on the Science and Technology Committee report Ageing: Science, Technology and Healthy Living. I thank the Minister for making time to respond to the debate. I am hoping that, being new in the post, he might have a more positive response to the conclusion of the report than the one we got from the Government.

It is a compliment to the committee and its report that so many notable noble Lords are taking part in the debate. I thank them all and look forward to their contributions. I sincerely thank all the committee members. I could not ask for a more committed, passionate, understanding, gentle, malleable and only occasionally challenging committee—or maybe not. I thank them all for their hard work and tolerance.

The committee was fortunate to have talented, hard-working committee staff: our clerk, Dr Simon Cran-McGreehin, policy analyst Dr Amy Creese, and committee operations officer Cerise Burnett-Stuart. I thank them for their hard work in running the committee and producing the report. The committee was well advised and supported by our specialist adviser, Professor Janet Lord, professor of immune cell biology and director of the Institute of Inflammation and Ageing at the University of Birmingham. On behalf of the committee, I thank her for all the help and advice she gave us.

We started our inquiry in July 2019 but had to delay concluding evidence sessions and publication because of the pandemic. It has already become clear that those who are old, who suffer from multiple comorbidities and who are socially deprived will pay the highest penalty as a result of Covid-19, compared to the young and healthy.

The background to our inquiry was a government publication in November 2017 naming an “Ageing Society”, as one of four “Grand Challenges” of the industrial strategy. It committed to

“harness the power of innovation to help meet the needs of an ageing society.”

In 2018, the Government announced that the mission of the ageing society grand challenge was to:

“Ensure that people can enjoy at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest.”


The aim of our inquiry was to understand to what extent developments in science and technology related to ageing will be important to reaching the goal of the Government’s grand challenge of an ageing society.

We also considered how current public health policies and co-ordination of healthcare for older people may contribute to years spent in poor health. Demographic projections suggest that, by 2035, 7% of people—some 5 million of the population—will be aged over 80. Life expectancy continues to rise, but the rate of rise is slowing. There is a strong link between deprivation and life expectancy. Males in the least deprived areas live nine and a half years longer than those in the most deprived areas. For females, the gap is 7.7 years. A more important measure than life expectancy is healthy life expectancy. The average age of healthy life expectancy in England is 63 years, with males spending a further 16 years—20% of their lifespan—and females 19.4 years, which is 23.3% of their lifespan, in poor health.

Inequalities in healthy life expectancy are even starker than those for life expectancy. The difference of 18.3 years in healthy life expectancy between the least deprived and most deprived is striking, with 70.6 and 52.3 years of healthy life respectively. Prioritising reducing health inequalities will have huge gains for health and for the economy.

Data from deaths from 2003 to 2018 show that that one-third of the deaths in England are attributable to social inequality. The King’s Fund report of September 2021 says that the Government have

“failed to make significant progress in reducing inequalities”.

While there is clear understanding of the lifestyle and environmental factors throughout life that correlate with good health, interventions in public health do not seem to be effective. Public health interventions need to find ways to motivate and to facilitate change to a healthier lifestyle, particularly for those living in deprivation and suffering the worst health. A child in year 6 from one of the most deprived areas is twice as likely to be obese compared to a child from a well-off area.

Ageing is a major risk factor for a wide range of diseases. Older people often have more than one health problem, often referred to as multimorbidity. Some 14 million people in England have two or more health conditions and 4.7 million have more than four health conditions. The health system currently fails these people for lack of co-ordination of care, with polypharmacy and overprescribing adding to their misery and making them sicker. The report indicated ways of reducing overprescribing, particularly in older patents with multi- morbidity.

I am pleased to see that the report on overprescribing from the Chief Pharmaceutical Officer confirms our views, with one in five admissions to hospital of the over-65s and 6.5% of all hospital admissions related to overprescribing. The Government did not accept our recommendations to help reduce the problem. When will the Government publish their response to the Chief Pharmaceutical Officer’s report and the implementation plan?

From a biological perspective, ageing is the result of an accumulation of a wide variety of molecular and cellular damage over time that leads to decreased physical and cognitive function, increasing the risk of illness and death. A recent animal study suggests that an ageing immune system may play a critical role in diseases related to age. The timing of these changes is not fixed, hence a person’s biological and chronological age can be out of step. Genetics, lifestyle and environmental factors may all have a role. Ways to measure how well a person is ageing will help science to develop understanding of the biological effects of ageing and how they can be modulated.

Understanding the biological pathways that lead to multisystem ageing will help us to discover new diagnostics and technology. Cellular senescence and deregulated nutrient sensing are two good examples of hallmarks of ageing. Understanding biological processes opens up the potential for developing new therapeutic interventions that could reduce or even reverse biological ageing and decrease the risk of developing disease. For example, targeting senescent cells which cause inflammatory changes in tissues leading to disease may allow us to develop senotherapeutics. Some repurposed drugs have already shown promise in mitigating age-related tissue damage.

Despite my enthusiasm for speaking more about the science related to ageing, there are several eloquent speakers taking part in today’s debate who have greater knowledge than I do and can—and I hope will—say more. The recent government report Life Sciences Vision identifies two key areas for research that relate to ageing. The first is improving translational capabilities in neurodegeneration and dementia. No doubt my noble friend Lady Greenfield may have more to say on that. The second is research into better understanding of ageing-related pathways. It is suggested that funding should come from partnership with industry. What plans do the Government have to implement those proposals? Our report recommended increased funding for ageing-related research and better co-ordination. I am pleased that UKRI has taken some recent initiatives in funding such research, but who will provide the necessary co-ordination, for which our report indicated a need?

I now come to the ageing society grand challenge and the mission of extending healthy life by five years by 2035. Our single conclusion in the report was that the Government are not on target to deliver on it, with lack of leadership and lack of a clear plan being major barriers. Different government departments had a role, but no one had responsibility for leadership or co-ordination. I hope that the Minister can confirm that the Government are still committed to the ageing society grand challenge of extending healthy life expectancy by five years. If that is the case, who will lead on it? When will the Government publish a detailed plan with timelines to achieve it? Who will independently monitor progress and will Parliament be able to review progress on a regular basis?

Any plans to extend healthy life expectancy cannot succeed without also addressing inequalities in health outcomes. The Government had said that they would publish their response following the end of consultation on the prevention Green Paper to address health inequalities. When will they publish their response? The Government are to publish the levelling-up White Paper by the end of the year. Will the White Paper address the issues related to inequalities in health and the means of reducing them?

In conclusion, research to better understand the biology of ageing, developing technologies, diagnostics and treatment for age-related diseases and keeping people healthy longer are the themes that our report tried to address and to suggest possible solutions to. Although the Government’s initial response was disappointing, there are now some positive signs and promise of more, so I remain hopeful.

I end with a plea to the Minister. I know that he will have a long brief to read out in response to today’s debate. My plea to him is to leave some time to answer the questions raised by noble Lords today and not just read the brief. If he does that, he will make himself very popular. I beg to move.

--- Later in debate ---

[Lord Patel (CB)]

My Lords, I will not keep you longer than half an hour. I am joking, of course. First, I thank the Minister very much for his response. I teased him to start with not to read his brief, but to try to answer the questions and, I have to admit, he attempted to answer the questions raised by all noble Lords. On those that he was unable to answer, he promised to write, and I thank him for that.

He confirmed that the grand challenge of adding five years to healthy life expectancy by 2035 is still government policy, but did not say who is in charge, who will monitor and who is going to report on progress to Parliament. At least this gives the Science and Technology Committee the opportunity, in a couple of years maybe, to review it and see what progress we have made, so he has been warned. He had better be on your guard, as we or some people might come back to him.

He answered the questions, but there was still a lot of “in due course”, so we will look forward to the reports that we will receive in due course. I wrote down at least five that he mentioned and I particularly look forward to the levelling-up White Paper, which is coming, because a lot of issues about inequalities need to be addressed. Once the NHS Office for Health Improvement and Disparities is established—it uses the word “disparities”—I hope to see a plan of how it will go about its task of reducing disparities.

I thank all noble Lords who took part today. All the speeches were excellent. I thank all my colleagues on the committee, because the attendance of Members, past and present, was spectacular, as were their speeches. I was also impressed by others, who were not part of the committee and by their backgrounds—economists, engineers, neuroscientists, those with decades of experience of the ageing process, nurses, accountants and an actuary. You suddenly start measuring your life’s limits. I did not declare an interest, as other noble Lords did, about their age or illnesses. I am 16, going on 83, and I intend to be 17 sometime. I thank noble Lords and beg to move.

Motion agreed.