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Joan Brown

Joan Brown, 89, and other pensioners march through Blackpool to attend the annual Pensioners Parliament.

The Age of Maintenance

How should England care for its elderly population?

BY Jane Miller

Easily my favourite old-age statistic has it that if most of us can look forward to living for about 10 years longer than our parents, we can also expect to spend the equivalent of eight of those years in hospitals or doctors' waiting rooms, maintaining ourselves. That's a loose approximation, of course, but it offers a sense of what it is to be old these days. And if you add to that all those exercises people recommend we perform at least 10 times a day, and the walking and the swimming and the procuring and cooking of only the greenest and healthiest food, we're pretty much back where our parents were. We are even advised to do crosswords in what must surely be futile efforts to ward off Alzheimer's. We could easily spend every minute of those additional 10 years simply managing to stay alive.

What does woman want? Freud asked, rhetorically and a little petulantly. And “woman,” you notice, not “women.” So, what does old want? Well, we certainly don't all want the same things, though efforts to mollify us or garner our votes tend to suggest that we do. I suppose most of us want some company and some independence. We get free bus passes and television licences in this country, and a little help with our fuel bills. The recent “granny tax,” introduced in the last budget, freezes the tax allowance for the old, which used to rise each year in line with inflation. It doesn't affect those too poor to pay taxes and it means virtually nothing to anyone in possession of an above-average income. But the group in between will be unfairly deprived of exactly what gave them some security against rising costs.

A recent report commissioned by the Conservative government, but dropped from any immediate legislative plans, describes the provision of care for the neediest pensioners and those in the middle as “broken,” and maintains that hundreds of thousands of old people are living in “misery and fear” because of the cuts in funding and of uncertainty about the future.

At a recent conference in North London, convened by several organizations promoting the interests of the old, the message was clear: More than anything, the old would like their health and welfare problems dealt with under one roof and preferably by the same people. They are exhausted by going from doctor to hospital to offices that deal with housing, with care, with pensions, with tax issues. Simply merging health and welfare services would cut down on the waiting. It might also mean that some doctors and nurses and administrators would be trained and experienced in considering us as a whole, not just as feet or bladders or necks or, indeed, minds. Accompanying an ill friend to a consultant surgeon the other day, we were both moved to tears when the doctor asked him what work he had done before he retired, and then a further question about that work. Those are rare questions.

There are disastrous plans afoot to “reform” the National Health Service just at the point when there has been a marked and acknowledged improvement in most aspects of healthcare and, especially, in the reduction of delays to treatment. “Choice” is the buzzword. The Health Service is to be opened to private bidders of all kinds, and the chances of standards being maintained, let alone improved, look slim indeed. It is not even clear that these “reforms” will save money, but they will put money in the pockets of some private providers. Care for the old, whether in their own homes or in residential homes, is funded inadequately and separately from health, and this government, like previous ones over the last 20 years, has done no more than wring its hands at the prospect of a swelling population of centenarians, with no plans to do anything about it.

So what does this old woman want? First, I'd like a center for the old, run mostly by old people, which offers us advice of all kinds. Then, I'd like a young unemployed person versed in technology (as any such person is likely to be), to visit me regularly and teach me to deal with my computer and my newly digitalised television set. Finally, I'm afraid I'd like the Olympics to be over, so that London can return to its shabby self instead of being in a state of perpetual, traffic-stopping renovation.

Jane Miller first worked in publishing, then as an English teacher and finally at the London University Institute of Education. She retired as Professor Emeritus in 1998.

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