Select Committee on Science and Technology First Report


FIRST REPORT

The Science and Technology Committee has agreed to the following Report:—

EQUAL (EXTEND QUALITY LIFE)

Introduction

1. EQUAL stands for Extend Quality Life. It is an Office of Science and Technology (OST) initiative, announced in July 1995, which aims to use "the combined resources, expertise and capacity for innovation of the science and engineering base to extend the active period of people's lives".[7] In the press release which announced the programme, EQUAL was ambitiously described as a "new blueprint for Science, Engineering and Technology policy in Britain".[8] It was made explicit that the "OST's continuing rôle in co-ordinating science policy across Government" would be a key feature of the programme and that "some of the Foresight Challenge Fund should be directed towards the components of EQUAL".[9]

Conduct of the inquiry

2. We announced our inquiry into EQUAL in October 1999 and called for evidence by 10 January 2000. Our aims were to consider —

3. We received 27 memoranda from a range of organisations and conducted four oral evidence sessions. We took oral evidence from Dr David Metz, Director of AgeNet; Professor (now Sir) George Radda CBE and Dr Diane McLaren of the Medical Research Council (MRC), together with Professor Ray Baker and Dr Alf Game of the Biotechnology and Biological Sciences Research Council (BBSRC); Lord Sainsbury of Turville, Minister for Science, Department of Trade and Industry, together with Dr John Taylor OBE, Director General of Research Councils, Office of Science and Technology; and Baroness Greengross of Notting Hill, Director General of Age Concern England. We would like to record our gratitude to all those who presented evidence to our inquiry.

4. We would also like to thank our specialist advisers for this inquiry: Professor Janet Askham, Director, Age Concern Institute of Gerontology, King's College London; Professor Derek Burke, former Vice-Chancellor of the University of East Anglia; and Professor Michael Elves, former Director of the Office of Scientific and Educational Affairs, Glaxo Wellcome plc. Their advice and assistance has been invaluable.

The importance of EQUAL

5. It is well known that, although the United Kingdom already has an aged population, the number of older people will rise markedly over the next thirty years, as the post-war 'baby-boom' generation ages. Perhaps more importantly, the proportion of older people in the population will also increase, as a result of continuing low projected fertility rates and rising life expectancy. These trends are common to developed societies across the globe and not unique to the United Kingdom. Indeed there are recent suggestions that official projections may be under-estimating life expectancy, with a new mortality forecast suggesting that "by 2050 the populations in these countries (the G7 nations) may be living from 1.3 years (UK), to 8 years (Japan) longer than official estimates now predict".[10] Moreover, the recent completion of the first stage of the human genome project raises the long term prospect of even longer life expectancy.

6. Increased life expectancy is something of which societies can be proud. In the past such increases were largely the result of improvements in living standards, in public health and particularly in the control of infectious diseases, the environment and medical care in infancy. More recently the effects of these improvements have been increased by better medical care and higher standards of living in late middle and old age. In fact, the United Kingdom may not have cause for as much pride as some other countries. For example, while life expectancy at age 65 in the United Kingdom has risen to 79.8 years for a man and 83.3 years for a woman, the equivalent figures for the USA are 80.9 and 84.4 years. Our life expectancy, as currently projected, is lower than that for people living in countries such as France and Japan.

7. Although life expectancy in later life has improved, healthy life expectancy has not risen to match it. As a recent overview states:

"Life expectancy at birth has greatly increased (in developed societies) over the last thirty years while the overall value of life expectancy without disability or handicap ¼ seems to have remained the same.".[11]

This is the stark reality: for all our success in increasing life expectancy, we have failed singularly to extend the length of healthy life.

8. There is still debate, however, about whether the level of disability which continues to afflict the older population is in itself changing. There is evidence that there has been an increase in mild levels of disability but a decrease in more severe disability. Although this has become the general consensus, recent findings for Britain show that there has been an increase in the prevalence of more severe disability.[12] Worryingly, the authors of the study found that:

"The prevalence of disability reported in the 1996/7 (Disability) survey was much higher than in the earlier 1985 survey of disabled adults in private households. None of the methodological differences we were able to examine accounted for this".[13]

There was no "suggestion of greater relative increases in mild rather than more serious disability, except in the eighty and over age group".[14] For, with increasing life expectancy also comes an increase in incidence of late-onset disabling conditions and diseases such as for example Alzheimer's Disease, and other chronic degenerative diseases of the brain and musculo-skeletal system. These are now imposing greater burdens on individuals, families and society.

9. The evidence that the extra years gained include extra years of disability (whether milder or not) is what makes initiatives such as EQUAL so important. The evidence raises the questions of how we can afford to provide for an increased proportion of older people who may need health and social care and whose later years may be dogged by low quality of life, and of how we can lessen this disability and improve people's lives. It is the latter question which EQUAL was set up to address.

10. According to the OST, the period "during which individuals and groups of people may expect to enjoy active, fit and participative lifestyles" can be extended through —

"harnessing a broad range of science and engineering outputs to overcome the mental, physical or other disabilities which are affecting an increasing number of people due to this expansion in the elderly population.".[15]

The assumption behind this initiative is that the United Kingdom had not previously been harnessing these outputs adequately and needed a more focused approach to research. Some of those who gave evidence to us admitted this. The Economic and Social Research Council (ESRC), for example, told us that, despite some pre-EQUAL initiatives on its part, "UK social science has under-invested in research on ageing compared with the United States and some of its EU partners".[16] There are, for instance, several well-established gerontology research centres in France and Germany and a more recently announced research programme on ageing in Finland has been allocated nearly £2 million over two years.

Areas of research relevant to EQUAL

11. To extend the active period of people's lives may mean improving their physical or social environment or the individual's physical and psychological characteristics (or the relationship between the two). First, there is a need for research to investigate the causes of low quality of life and determine what should be done and how to improve it. After that come alterations in, and developments of new, services, facilities, products, treatments, and programmes together with the careful evaluation of innovations. EQUAL so far has concentrated on the first area, but has included some developmental work.

12. The major relevant areas for research are —

13. Research in these kinds of fields almost inevitably requires a multi-disciplinary approach, since there are such close connections between, for example, health, morale and activity, income, well-being and use of services. Differing methods will also be necessary; some of the research questions may be addressed by short-term experimental or survey approaches; others will require a longer timescale (for example, a longitudinal survey) or a multi-site design. We welcome the English Longitudinal Survey being led by University College London, but find it bizarre that it is being 50% funded by the US National Institute on Aging, with less than 50% by UK Government Departments.

14. An area which has been neglected in the past is the needs of older people from ethnic minorities. We welcome recent research that has been done to identify the particular needs of older people from black and ethnic minority communities. Future research into ageing must take ethnicity fully into account.

15. EQUAL provides the potential to focus research and development on the growing need of an ageing society for improvements in quality of life in later years. There is a pressing need for research directed both towards those who are already old, and towards the next generation, particularly those in their 40s and 50s whose old age we may be able to improve significantly.


7  
Department of Trade and Industry Press Notice, 20 July 1995, P/95/487. Back

8   Ibid. Back

9   Ibid. Back

10   Tuljapurkar S, Li N & Boe C (2000): A universal pattern of mortality decline in the G7 countries, Nature, pp 405,6788,

789-792. Back

11   Robine J-M, Romieu I & Cambois E (1997): Health expectancies and current research, Reviews in Clinical Gerontology, pp 7, 73-81.  Back

12   Grundy E, Ahlburg D, Ali M, Breeze E and Sloggett A (1999). Results from the 1996/97 Disability Follow-up to the Family Resource Survey, DSS, Research Report No. 94. Back

13   IbidBack

14   IbidBack

15   Evidence, p 28, paragraph 3. Back

16   Evidence, p 81, paragraph 7. Back


 
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Prepared 17 January 2001