Speech by Prof. Chris Phillipson, Professor of Sociology and Social Gerontology, The University of Manchester at the 67th The Almshouse Association Annual General Meeting on 13th June 2018 at The Worshipful Company of Merchant Taylors, Merchant Taylors’ Hall, 30 Threadneedle Street, London.

 

 The Future of Ageing Populations: Managing Diversity and Inequality

I very much appreciate this invitation to address the AGM and I would like to pay tribute to the remarkable work undertaken by the members of the Association in supporting older people living in the community. Just to summarise my own background: I have been involved in research on older people since the 1970s, working as a sociologist on different projects relating to family and community care, work and retirement, and more recently how we develop age-friendly cities and communities.

Looking back on this work from the vantage point of 2018 I have a feeling of, yes, much has been achieved in better support for older people but on the other hand there is also a sense of real crisis which is affecting some groups of older people and which I am sure is echoed in some aspects of your own work. Let me just set out some issues and dimensions of current challenges but more positively some responses which I think we can make.

First, population ageing is of course the fundamental context for your work: The number of people aged 65+ is projected to rise by over 40 per cent over the next couple of decades to around 16 million. By 2040, nearly one in four people in the UK (24.2%) will be aged 65 or over. For myself as a sociologist, what is more striking though – and which will be very important for your own work – is that this will be a much more diverse population than has historically been the case:

Diverse in terms of attitudes towards ageing with people searching for more ambitious lifestyles in later life; diverse in terms of the transitions which people experience – no longer education/work/and then retirement – but much greater flexibility and multiple stages across the life course; diversity in income – presently taking couples the poorest fifth have £224 a week compared with the richest at £911 a week: and this gap is of course widening as inequalities increase in our society; and diversity in social characteristics – especially in respect of gender, ethnicity, and social relationships more broadly. So thinking about ageing – and who older people are – is now much more complex, with great differences within groups of older people as much between older people and other generations.

So, we all recognise the importance of this changing population, yet the reality is that as a House of Lords enquiry (Ready for Ageing?) reported in 2013, we are still largely ‘unprepared’, as final report put it, for an ageing population. You will know from your own experience the current crisis in social care, but the figures are striking: whilst the number of older people has been growing local councils have seen a 26 reduction in their budgets since 2009/10. Over the period 09/10 to the past year, the average spend on social care fell by 13 per cent; again over this period, 400,000 fewer older people were receiving social care as the eligibility criteria was tightened in response to fewer resources.

And of course the reality on the ground is: lengthy waits for assessment; disjointed services; huge pressures in carers; and a crisis in the quality of care. The latest report from the Association of Directors of Social Services suggests that three-quarters of councils are proposing further cuts in the services they provide, with one half proposing further increases in charges associated with home and forms of care.

Now my argument is that at present we are completely stuck in terms of responding to this situation: we have moved from the world of the welfare state of the 1960s and 1970s – which for all its imperfections was starting to provide a framework of support; through to the world of privatisation but realising now that this cannot provide the essential and secure support which people at periods of great vulnerability need: the closure of residential homes, and continuing problems in ensuring quality in home care illustrating this point.

So we have to have a debate now about where we move to in respect of care for older people: what kind of future do we want to construct in response to the current situation? This seems to me a debate which the Association needs to have and to influence along with many other groups. Let me in offer just a few thoughts from my own work.

First, I think it continues to remain important to thinking about ageing in more positive way and challenging negative stereotypes. There has been a disturbing development in terms of debates and reports which focus on intergenerational conflict and older people as a burden on younger generations when the reality of course is continued reciprocity – financial and social – across generations. And ageism – systematic discrimination against older people – continues to be a real issue, as a report published last week by the Royal Society of Public Health illustrated: so, there is an important task here for the Association in contributing to the debate about the way older people are both transformed by society but are themselves changing the communities in which they live – in very positive ways given the strengths which they bring.

My second point here is about these communities. Here the government have held up ‘ageing in place’ as the preferred ideal for older people – staying in their own homes or indeed a facility such as that of the members of this Association for as long as possible. This makes sense: around 80% of the time of people aged over 70 is spent at home or the immediate environment. The home and neighbourhood are central to social connections and social support. But as we have seen whilst the community has been emphasised we have reduced formal help going into neighbourhoods. We urgently need a response here which of course is about resources but also about how we organise and develop our work.

Here, it seems to be housing is central to re-thinking policies for later life: housing for too long has been the poor relation to health and social care but in reality if we get housing and all that is associated with it right we go a long way to ensuring support for older people. The task here is:

  • first, ensuring integration of housing with the other major services;
  • second, getting greater innovation in terms of the types of housing;
  • and, third, getting more joined up thinking about housing adaptations and home repairs. The Housing Learning Information Network has produced important reports in these issues and these are I am sure helpful to the work of the Association.

But a final important is that we need to integrate work around housing by strengthening the communities in which people live. Here, I think the initiative of the World Health Organization to develop age-friendly communities has been helpful and we are seeing the expansion in the UK of work around this initiative – co-ordinated by the Centre for Ageing Better. My own work in Manchester has been around working with groups of older people around a range of interventions, including:

  • Promoting neighbourhood networks: to combat social isolation and provide support to informal carers;
  • Support co-operative enterprises drawing on the skills of older people and
  • Environmental interventions: promoting the importance of local parks, age-friendly shops and improving transportation.

The key here is working with a range of groups in communities in promoting change and drawing on the skills which older people bring to social and community action. Just on this point, I would like to finish with this quote from two American researchers in evidence submitted to a US Senate committee on ageing:

‘Population aging will transform the global community. The question is whether such changes will better societies or extract net tolls. Either is possible. If we continue to view the life course as our ancestors did and simply tack added years on the end we face calamity. If instead we begin to modify the life course and build infrastructures that support long life, societies can begin to utilize the strengths of older people and support the real vulnerabilities of advanced old age’

(Carstensen, L. & Fried, L. Submission to US Senate Commission on Aging)