Buried at the bottom of a recent ONS report thrillingly entitled “National Population Projections: 2016-based statistical bulletin” we found an alarming revelation: for the first time in 110 years, life expectancy for pensioners in the UK has fallen. Due to a stall in improvements of mortality rates, men aged 65 are anticipated to live a further 22.2 years, down from 22.8 years in 2013, and women a further 24.1 years – down from 25.1 years four years ago.
That’s a big drop.
Why? The easy answer is that the low hanging fruit has already been picked. Smoking – which contributed to early deaths for decades – lost popularity in the late noughties, and thanks to countless awareness campaigns and heavy legislation, air pollution massively improved between 1950 and 2000.
But this explanation doesn’t go far enough. Life expectancy for women in the UK is now lower, and often much lower, than in Austria, Belgium, Cyprus, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Liechtenstein, Luxembourg, Malta, The Netherlands, Norway, Portugal, Slovenia, Spain and Sweden – even though the public health trends in all these countries have pretty much mirrored the trends in Britain for the last four decades.
The painful truth is that successive governments in this country have chronically neglected the elderly, and we are now witnessing the results of that neglect.
It may sound melodramatic, but it isn’t. An alarming report by researchers at Liverpool, Oxford, Glasgow and York universities has directly connected much of the stalling in health improvements to delays in discharging patients from hospital due to insufficient older adult social care, and concluded that mismanaged and poorly funded elderly care could account for up to a fifth of mortality increases.
It’s a disturbing read, but not a surprising one. The current funding model (which relies on a mixture of local council contributions, and individuals paying for themselves) is an unsustainable mess. It never worked particularly well because areas with disproportionate numbers of elderly people historically struggled to fund care homes through council tax without scaring off those of working age – and now, it has reached breaking point.
Cash strapped council funded care homes (for those eligible for free care) are being forced to close thanks to a squeeze on staff brought on by an increase in national living wage, while on the other side of the divide, the Government has quietly scrapped its commitment to put a £72,000 cap on care costs for elderly people who are deemed able to pay for themselves.
What’s particularly frustrating about the current situation is that if Theresa May’s team (I’m looking at you, Nick Timothy) had been a little less ham-fisted when selling the manifesto reforms on elderly social care to the public, the picture may well be a whole lot brighter.
Under the current dysfunctional rules, if you have assets worth more than £23,250 you (or your family) are expected to pay for the full cost of your social care. Anything below that, and the local council pays. Crucially, this figure does not include the value of your house, meaning cash-poor pensioners living in multi-million pound mansions can get free social care, then pass on their property to their descendants when they die.
As well as being ludicrously unfair on pensioners who aren’t rich but have prudently saved for their retirement, this way of doing things simply doesn’t pump enough cash into the system. Only a vanishingly small number of pensioners have 23 grand’s worth of disposable cash, and everyone else ends up mining the council’s cash reserves.
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The fair and sensible reforms outlined in the manifesto would have eliminated the property loophole by raising the threshold to £100,000, but including the value of houses.
Although far from perfect, this policy provided a practical solution to an impossible problem – and would have meant a huge boost for care funding.
Unfortunately, because of a disastrously mishandled campaign, and a too clever by half journalist who came up with “dementia tax, it was misinterpreted, fudged and then scrapped.
And now the poor, elderly and vulnerable are facing what is predicted to be the worst winter yet.
There is a glimmer of hope in this grim picture, and that’s the green paper on elderly care which is due to be published next summer. It’s a small step, but it’s a start, and it’s encouraging that experts including Dr Anna Dixon, chief executive of the Centre for Ageing Better, and Margaret Willcox, president of the Association of Directors of Adult Social Services, have welcomed it.
This Government may never get back its pre-election, reforming confidence, but if it even takes a few tentative steps towards sorting out the disturbing drop in life expectancy, it may just salvage itself a positive legacy