Tuesday, 22 May 2012

As we all get older, do we have the doctors we need?

Not sure whether I have to declare an interest here: I’m writing about age and I am, after all, growing older.

On the other hand, so’s anyone who reads this. What’s more, that’s not just true of us as individuals but also of the societies we inhabit, at least if we have the good fortune to live in one of the wealthier nations. For instance, in Britain between 1901 and 2008, life expectancy grew by 32 years for men and 33 for women. Perhaps even more striking is the finding that life expectancy at 70 is 17 years for men and 19 for women.

Why do I know all this? Because I’ve been reading some articles by David Oliver. He’s the National Clinical Director for Older People’s Services in the English Department of Health and he takes positions on questions of ageing that are both refreshing and challenging.

For instance, he points out that ‘the constant public dialogue of population ageing as being a ‘timebomb’, ‘tsunami’, ‘burden’ or ‘crisis’ is unhelpful scaremongering which colours our attitudes to older people.’ Instead, we should be taking satisfaction from our success in extending life, and realise that it is because of that achievement that we have more older people around: in 1901, 5% of the population was over 65, in 2008, 19%.

There are of course challenges associated with this change, and Oliver delights in throwing down a few himself. Particularly to his own profession. At a conference attended by young or training doctors, he asked:

‘Who in the room wants to spend much of their career looking after people who can’t be cured of their long term conditions or disability, older people, including the ‘oldest old’, the vulnerable, the dependent, the demented and the dying?’

Strong words and one can imagine not many would hold up their hands. But to those who didn’t he had a stark message:

‘You need to get into paediatrics, maternity, a lab-based speciality or under 65 mental health/disability services.’ Or leave the profession. Or leave the country.

Healthcare is changing. We still have a specialty called ‘Care of the Elderly’ but you don’t have to be in it to be treating old, in some cases very old, people. 60% of hospital admissions in England are for patients aged 65 or over, 70% of the bed days are consumed by them. You may be in General Medicine, Rheumatology or Gastroenterology, but sheer demographics are increasingly making your case mix look like a Geriatrician’s.

But Oliver isn’t just saying, ‘that’s the way it is, live with it.’

He’s saying, ‘that’s the way it is, celebrate it.’

Which is good news for all of us when you come to think of it. After all, we’re none of us getting any younger.

Well may he smile: it's not all bad news


Awoogamuffin said...

One thing we also need to is, as a society, appreciate the skills older people bring to jobs. It seems that England is relatively good at this, but in Spain being over 50 seems to make you unemployable.

I saw this quote today which seems apt:

"It is time I stepped aside for a less experienced and less able man."
- Scott Elledge, on his retirement as a Professor at Cornell

David Beeson said...

Brilliant! That about sums it up