Stewart Sutherland thinks the UK could do better

Although life expectancy is increasing, so are the years of ill-health at the end of life.
The House of Lords Science and Technology Committee recently held an inquiry to consider how science and technology might contribute to this trend being corrected and reversed.
 
The NHS undoubtedly devotes a large proportion of its resources to the care of older people, and the diseases which are particularly prevalent in old age. A recent Department of Health report (see 1 below) stated that ‘health in old age is improving and should continue to improve’. But the opinion of the Department’s own officials was that while life expectancy is increasing, health in old age is not.

Resources
If resources were focused more on the prevention of disease rather than its treatment, the later years of life might increasingly become years of good health.

One example particularly impressed the Committee: countries such as Canada have a far higher proportion of stroke patients making good recoveries. The main reason seems to be that they position brain scanners in A&E departments with the aim of diagnosing the stroke as soon as possible. In this country, fewer than half of stroke patients have a scan performed within two days of the stroke. This is just one small change which could greatly improve the outcome in terms of both fatalities and dependency.

Research
In the longer term, it is research into the problems of old age, and the diseases particularly prevalent then, which will make a difference. We found that this type of research is very much the poor relation. Four of the research councils are responsible for different aspects of ageing-related research. Of these, the MRC states that it devotes 28 per cent of its budget to ageing-related research, but much of this goes on projects which have only a marginal connection with ageing. The ESRC spends only a lamentable 1.2 per cent of its budget on this research. We recommended that this should be greatly increased. 

The Committee also thought that the coordination of ageing-related research was woefully inadequate. A succession of bodies supposedly responsible for this coordination had inadequate resources and powers, and signally failed in their task. We visited the US National Institute on Aging and admired the work they do.  A similar body would not be appropriate for this country, but we said that the Office of Science and Technology must set up a coordination body with the necessary constitution, membership, powers and funding. When it can attract the best researchers to this type of work and coordinate their efforts, the prospects for better health in old age should greatly improve.

Lifestyle
In the still longer term, health in old age reflects what happens in youth. Physical activity, good nutrition, and absence of risk factors (such as smoking and excessive drinking) all promote good health and slow the ageing process. Inadequate exercise and lack of education about health matters contribute to the startling variations in life expectancy between different social classes and different geographical regions, which can amount to as much as ten years. Halting the sales of school playing fields is just one way in which health in deprived areas could be improved.

Technology and ageism
We looked too at technology. It is largely already there, but is not being applied nearly as much as it might to improve older people’s quality of life. We found a generalised failure by industry to recognise the enormous potential of the market which older people represent. This is largely a matter for industry itself to resolve.

This is part of a wider problem. Old age is still regarded in a very negative light. What concerned us was the pervasive but often unrecognised ageist attitude of the public and the media towards diseases prevalent in old age, and the ageist approach of industry to older people as consumers. We believe the government could do more to help combat these attitudes, directly through government departments and the NHS, and indirectly by its influence on schools, industry and the media.

References
1. Better health in old age: Professor Ian Philp’s report to the Secretary of State, November 2004

Lord Sutherland of Houndwood chaired the inquiry