Social care through a global lens

In 2019, there were 703 million people aged 65 and over in the world. That number is predicted to double to 1.5 billion in 2050, with one in six people in the world aged 65 or older..

While we should of course celebrate the increase in longevity that we will hopefully all enjoy, it also is not a population shift that can be managed without significant changes to the way in which we all live. Climate goals are firmly embedded in our psyche, but the call for a transformation in approaches to ageing does not get anywhere near the same profile, yet the impact on communities, people, economies and rights all require our attention. ‘Zero ageism’ should be our 2050 slogan, as a focus on the rights of older people will lead to a care system fit for the future.

However, much like the climate challenge, despite the irrefutable demographic data, the time frame for change far outstrips any incumbent political party's ambitions for tenure in office. Governments know that complex and far-sighted attempts to address societal agendas are often trumped by the electorate’s drive for actions that impact on the here and now. This must change.

That is why I am very pleased to be part of the Global Ageing Network which has published a ‘call to governments’ across the world to think about how long-term care needs to transform in order to ensure that those ageing have not only the care they need, but also receive it in a way that embodies the rights and dignity to live a full and positive life.

Organisations representing care providers and the voices of people receiving care and support have come together under the Global Ageing Network banner to call on governments to take action now, and have highlighted key areas which each and every government needs to have in mind.

Labour markets – movement and capacity

The focus on the UK workforce is unrelenting. The pay, terms and conditions of the workforce are the subject of endless reports and short-term approaches to address the ever-increasing levels of vacancies. However, if we only see this as a UK-wide issue, we are missing the bigger picture. In recent months the government has turned its attention to the opportunities that international recruitment brings, with new funding to increase the ability of care and health providers to recruit from overseas following the inclusion of both senior and front line care workers on the Shortage Occupation List. However, it is clear that not only will the UK need to be able to compete with multiple other countries seeking a care workforce to support their ageing population, but increasingly we will be competing with other countries such as Australia and Canada which have both indicated their desire to bring in a migrant workforce from the UK, alongside other countries, in order to address their shortfall in care staff. Migration of the care workforce is a reality, and looking for ways which recognise the portability of skills, expertise and workers’ rights need to be seen as international priorities. Solutions to labour shortages must be both ethical and underpinned by a constant drive to increase quality.

Economic factors

Economies across the world need to be identifying new ways to support the ageing population. The growing number of older people means there will be fewer working age people to contribute to the economy, and therefore a reduction in the ability of countries to rely on taxation or other sources of public funding to deliver long-term care. If this leads to increased reliance on unpaid carers, then there’s a well-documented correlation between increases in unpaid carer commitment leading to a reduction in their ability to engage in paid employment. In addition, the shrinking ratio between working age adults and older people will mean those available to provide unpaid care, even if that was their wish, will be reducing year-on-year. Models of care delivery across the globe are moving towards home-based approaches, with a strong focus on the potential for technology to meet needs. There is much to learn from each other, and we need the same ambition around global approaches to innovations in health, science and technology to tackle the future of care delivery.

Shifting sands

While there have been many medical and societal advances that enable a longer and healthier life, it’s still the likelihood that at least half of the growing population of older adults will need some long-term care services for a period of time in their lives. Working together as a global group, it’s clear to see that the experience of the UK is replicated across the world, with similar unsatisfactory outcomes. Care coordination everywhere is hampered by a fragmented patchwork of funding sources, budgets protected within silos, and all contribute to insufficient and inefficient care coordination. Integration of care is thwarted by the differential values, culture and training of health professionals and care professionals, leading to a lack of familiarity or understanding about what each other does. Too often, across the world, there’s a failure to understand the complexity of the delivery of care for older adults, leaving it outside the academic curriculum, and meaning that society rarely appreciates or acknowledges much-needed professional expertise and knowledge as core to the role of long-term care.

Sustainable care – a new vision

We need a new vision for the future, and that should encompass our desire for all to be able not just to live longer, but to live high-quality lives with dignity, respect, self-determination and independence. The Global Ageing Network is committed to challenging governments to help shape this vision and will be working with NCF and Scottish Care at the Global Ageing Conference in Glasgow on 7-8 September to this end. We are at a crossroads. As the ageing population grows, more of the same is not an option. It’s vital that governments across the globe take note and work together to ensure a sustainable future for long-term care. The electorate must make it clear that while individual governments come and go, the decisions they make in relation to ageing and care matter to us all.