Select Committee on Science and Technology First Report


CHAPTER 9: SUMMARY OF CONCLUSIONS AND RECOMMENDATIONS

9.1.  In this chapter we summarise our conclusions and recommendations. The numbers in brackets refer to the relevant paragraphs in the text.

The devolved administrations

9.2.  Some of our conclusions and recommendations to the Government relate to matters which, in Scotland, Wales and Northern Ireland, are within the competence of the devolved administrations. To this extent, our recommendations are not directly addressed to those administrations; but insofar as many of the facts on which they are based do not respect administrative boundaries, we hope that the devolved administrations too will consider implementing our recommendations with any necessary amendments and modifications. (1.11)

Demographic change

9.3.  At current rates, life expectancy within the UK is increasing at the rate of about two years for each decade that passes. The consequences of this demographic change for all aspects of life are profound. As this Report will show, we have found little evidence that policy has been sufficiently informed by scientific understanding of the ageing process. (2.16)

9.4.  We conclude that there is considerable uncertainty about whether healthy lifespan is increasing faster or slower than lifespan. The uncertainty comes from the variability in individual health trajectories through life, and the difficulty in applying objective measures of health and quality of life across different age groups. We believe that freedom from disability provides a more easily ascertainable objective measure of the quality of life. (2.29)

9.5.  Further research should be undertaken to validate and apply appropriate measures to monitor the trends in healthy lifespan. We recommend that funds should be made available to the Office for National Statistics to enable it to carry out over a number of years the surveys needed to assess disability-free life expectancy. (2.30)

Promoting good health: physical activity

9.6.  Local authorities can do much to help people of all ages, including older people, to benefit from exercise. Facilities for cycling are often poor or non-existent; sometimes even walking is a perilous activity. Local authorities should aim to improve facilities for exercise; they should make it their business to inform older people about these facilities; they should encourage them to use these facilities; and they should ensure that adequate transport is available. (3.25)

9.7.  Exercise at all ages is one of the most effective ways to counter the adverse effects of ageing on functional capacity. The Government should publish plans showing how they intend to promote, in schools and elsewhere, the benefits of exercise as a factor contributing to improved health at all ages. (3.28)

9.8.  Consent for the disposal of playing fields must be refused unless the facilities lost are to be replaced by sports or exercise facilities which are as good or better. (3.29)

Nutrition

9.9.  Nutrition and oral health have major impacts on health throughout the lifespan. Since a person's health in old age reflects molecular and cellular damage that accumulates throughout life, and since nutrition affects the accumulation of such damage (adversely in the case of poor nutrition, beneficially in the case of good nutrition), the links between healthy eating and healthy ageing need to be better understood and communicated to the public. (3.36)

9.10.  We welcome and commend the approach of the White Paper Choosing Health, and the importance it attaches to the provision of information about healthy nutrition. We recommend that this approach should be extended to cover the specific problems of older people. (3.37)

Individuality of the ageing process

9.11.  In the light of improved knowledge of underlying biological mechanisms and the need to measure the efficacy of interventions aimed at improving healthy ageing, we recommend that specific attention be given to funding research on biomarkers of ageing. (3.47)

9.12.  Most of the research on ageing and health within the UK is focused on specific diseases and medical conditions for which age is the single largest risk factor. However, there is little research on underpinning mechanisms of such diseases which may be linked to basic processes of ageing. The Department of Health and other medical research funders, including the major charities, should develop and implement strategies to address links between ageing and disease. (3.67)

Age-related diseases

9.13.  Stroke is a major cause of long-term illness, disability and death, particularly among older people. Yet significant reductions in the long-term health consequences of a stroke can be made if very early assessments and treatments are provided, for example by locating scanners within accident and emergency departments. The Department of Health should make rapid treatment of stroke a priority. (4.12)

9.14.  We recommend that the Government and research councils should, when allocating money to cancer research, place more emphasis on those cancers particularly prevalent among the elderly. We encourage Cancer Research UK to do likewise. (4.23)

Age-related disorders

9.15.  We recommend that the Department of Health should continue to take urgent steps to remedy the shortage of dentists, and to encourage a habit of more frequent check-ups, especially among older people. (4.51)

9.16.  Older people are disproportionately affected by many specific diseases and sensory impairments, and the expenditure directed at these diseases appears to be far lower than would be expected. A population with a growing number of older people will result in an increasing burden on society from some conditions for which age is a significant risk factor. (4.52)

9.17.  The Government should re-examine their research priorities, and promote expenditure on research into the alleviation of those conditions which disproportionately affect older people. (4.53)

The built environment

9.18.  The Office of the Deputy Prime Minister and the Department of Health should join with the Department for the Environment, Food and Rural Affairs and the Department of Trade and Industry in pressing ahead with the preparation of detailed plans for the elimination of deaths of older people caused by cold and damp, and should provide the resources to implement these plans. (5.11)

9.19.  We urge the Government to take forward urgently the review of Part M of the Building Regulations, to bring up to date the Lifetime Home Standards, and to amend the Regulations to incorporate the revised standards. (5.15)

Transport

9.20.  We recommend that, when reaching decisions on the review commissioned by the DVLA, the Department for Transport should not exclude the option of allowing licence-holders to determine for themselves the age at which they should cease to drive. (5.23)

9.21.  We believe the evidence clearly shows how older people enter into a negative spiral towards dependency through social isolation and inactivity, often founded on lack of access to suitable transport, amenities and opportunities for exercise. (5.33)

9.22.  Government, local authorities, transport companies and service providers should plan on the assumption that the average age of users and the proportion of older users will continue to increase. Compliance with regulations requiring provision for older people should be monitored. (5.34)

Communication

9.23.  We believe that some of the most exciting opportunities for scientific advance to benefit older people arise through use of information technology. Industry self-regulation has notably failed to address these needs and opportunities. (5.39)

9.24.  The Government's target should be that every home, including those in rural areas where social isolation of older people is often severe, should receive access to affordable high bandwidth IT connection within 3 years. If necessary, Ofcom should rely on its regulatory powers to secure this. Local authorities should offer older people training packages in the use of IT. (5.43)

Assistive technology

9.25.  The Department of Health and the Office of the Deputy Prime Minister should make funds available to local authorities to set up the infrastructure needed for third generation social alarms. Local authorities should work closely with industry and with charities concerned with assistive technology in carrying this work forward. (5.58)

9.26.  The Department of Health's investment in assistive technology should be extended to include technologies and devices that can assist in monitoring health conditions and detecting early signs of health problems by individuals in the home. (5.63)

Industry and commerce: the missed opportunity

9.27.  The Government's policy of encouraging older people to remain in their homes as long as possible will be thwarted if industry does not respond to this challenge. (6.17)

9.28.  The Government should consult with the Design Council, the Confederation of British Industry, the Institute of Directors, the Federation of Small Businesses, the British Chambers of Commerce, trade associations and trades unions on how they can best play an active part in developing these markets. (6.18)

9.29.  Like the Foresight Ageing Population Panel, we encourage manufacturers and the finance and services sectors to seize this opportunity simultaneously to benefit their older customers and their shareholders. (6.19)

The National Service Framework

9.30.  The Department of Health must set out clear and measurable standards for assessing the health of older people, with particular emphasis on the care and treatment of those diseases prevalent in old age. Claims that those standards have been met should not be made unless they are supported by hard evidence. (7.13)

9.31.  We welcome the appointment of a "Government champion of older people". We believe that this must be a single minister of Cabinet rank who, whatever his or her title and departmental responsibilities, has full responsibility for bringing together and implementing all aspects of government policy relating to older people. (7.20)

Cost effectiveness

9.32.  The initiation of studies of the cost-effectiveness of spending resources on prevention rather than treatment must be an important consideration for the Minister with overall responsibility for coordinating policy relating to older people. (7.28)

9.33.  There must be effective supervision to ensure that it is the overall cost to the taxpayer which is considered, and not the cost to the budget of an individual department, to the NHS or to local government. (7.29)

Clinical records

9.34.  The Department of Health and the NHS should consult with the scientific community as to how the data generated by the NHS could be improved, the regulatory framework simplified, and the bureaucracy reduced. (7.31)

Clinical trials

9.35.  The Department of Health and the research councils should take steps to ensure that older people are not routinely excluded from clinical trials, and that positive steps are taken to include them in the testing of medicines to be used to treat conditions prevalent among older people. The Medicines and Healthcare Products Regulatory Agency should ensure that the pharmaceutical industry does likewise. (7.35)

Longitudinal studies

9.36.  The Government should make additional funding available through the Department of Health and the research councils to implement joined-up programmes of longitudinal research on scientific aspects of ageing. (7.43)

Researchers

9.37.  Multidisciplinary and translational clinical research, which is particularly important for ageing, has been hampered by the Universities Research Assessment Exercise. The Higher Education Funding Councils should, as a matter of urgency, consider how this problem can best be addressed in the forthcoming Research Assessment Exercise. (8.15)

Funding of research: the research councils

9.38.  We recommend that the Economic and Social Research Council should urgently and significantly increase the proportion of its funding available for ageing-related research. The Director-General of Research Councils should supervise this. (8.29)

9.39.  The research councils should ensure that when their scientific committees are considering applications for funding for ageing-related research, they include a majority of members with specific experience in these fields. (8.32)

Funding of research: the European Union

9.40.  The Government must ensure that a very significant proportion of the resources allocated to the EU Seventh Framework Programme is set aside for ageing-related research. Members of the European Parliament should also press for this. (8.36)

Coordination of research

9.41.  Our conclusion is that the attempts at coordination so far made under the aegis of the research councils are woefully inadequate. The image we have is of a series of ill-thought-out initiatives which have long titles, short lives, vague terms of reference, little infrastructure, and no sense of purpose. A radical reorganisation is essential. (8.58)

9.42.  We conclude that the bodies currently responsible for the coordination of ageing-related research in the UK are not doing the job. The situation needs to be transformed. We believe however that this can be done without setting up a body modelled on the United States National Institute on Aging. (8.83)

9.43.  The responsibility for coordination must lie with the Department of Trade and Industry and the Office of Science and Technology. The Government's Chief Scientific Adviser will have an important part to play. (8.84)

9.44.  DTI and OST should set up a body with the membership, constitution, powers and funding necessary to provide the strategic oversight and direction of ageing-related research. (8.85)

9.45.  When deciding on the structure of this body, DTI and OST should learn from the successful structure of the National Cancer Research Institute. (8.86)

9.46.  Close collaboration with charities and private funders must be ensured by allowing them suitable representation. (8.87)

9.47.  There must be liaison with similar bodies in other countries, and developments in those countries must be taken into account. (8.88)

9.48.  Among the most important responsibilities of this body will be to promote research into ageing as a career for the best young researchers, and to supervise career development. (8.89)


 
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