Meeting of the Parliament

Meeting date: Wednesday, April 19, 2023

Official Report 1049KB pdf

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Healthy Ageing in Scotland

The final item of business is a members’ business debate on motion S6M-07967, in the name of Alexander Stewart, on healthy ageing in Scotland. The debate will be concluded without any question being put. Members who wish to speak in the debate should press their request-to-speak buttons.

Motion debated,

That the Parliament acknowledges that the University of Stirling-led Healthy AGeing In Scotland (HAGIS) study is the first of its kind to follow individuals and households across Scotland, including in the Mid Scotland and Fife region, through the passage of time; understands that the study, which was launched on 24 July 2015, is an ongoing, major Scotland-wide study of the health, economic and social circumstances of people over 50, which will enable future improvements to be made to the health and wellbeing of this age group; believes that there are currently two million people over 50 in Scotland, comprising 38% of the population; understands that the HAGIS study will capture a snapshot of the current circumstances of 1,000 people over 50; further understands that, following its findings in Autumn 2016, the aim was to expand the study to 8,000 people in 2018, charting changes in their health and social circumstances over the decades and reporting every two years; notes that the multi-partner HAGIS project team includes the Universities of Strathclyde and Edinburgh; believes that, while people in Scotland are now living longer and the size of the older population is increasing, the country historically possesses a relatively poor health record and significant levels of income inequality; considers that, as a result of its extensive research since inception, the HAGIS study is proving to be what it sees as an extremely valuable and important new member of the growing worldwide network of longitudinal ageing studies, uncovering the unique health and social circumstances currently experienced by Scotland’s ageing population; acknowledges the United Nations Decade of Healthy Ageing (2021-2030), which is a global collaboration, aligned with the last ten years of the UN Sustainable Development Goals, to improve the lives of older people, their families, and the communities in which they live; understands that the three domains of healthy ageing are physical ageing, mental/cognitive ageing and social wellbeing ageing; considers that harmonised data from HAGIS will permit quantitative comparisons of the ageing processes in Scotland with findings from the other members of the Health and Retirement Study family, which now covers more than 50% of the world’s over-50 population, and commends the University of Stirling and its multi-partner university project team for embarking on what it considers as a significant and invaluable study into the improvement of health and wellbeing in the lives of Scotland’s growing ageing population.

17:25  

I am grateful for the opportunity to bring this debate to the chamber this evening. I also thank members who supported today’s motion, which highlights the Healthy Ageing in Scotland study. It was led by the University of Stirling and focuses on the real-life day-to-day experiences of older people in Scotland.

Healthy ageing is an important issue for many people across the chamber, and I have no doubt that we will hear some thoughtful contributions. It is clear that the issue will become only more important to Scotland in the years to come. As we know, there are already more than 2 million people aged over 50 in Scotland, which equates to around 38 per cent of the population. We also know that Scotland’s population has been steadily ageing for the past 40 years—a trend that will continue. Indeed, the study highlights that there will be an 85 per cent increase in people aged over 75 by 2039, which is a higher increase than is expected in any other part of the United Kingdom.

The study provides first-hand details and insight into the lives of over-50s in Scotland, and aims to look at older people’s health, their economic circumstances and their social wellbeing. It is also Scotland’s entry into the Gateway to Global Aging Data platform, which provides data on over two thirds of the world’s over-50s population. A number of helpful reports have already come out of the study, including one that had a specific focus on how the pandemic affected the wellbeing of older people. That study highlighted the fact that the pandemic affected older people’s wellbeing at the time, and we know that older people depend on services that are recovering even today.

The truth is that the wellbeing of older people in Scotland was a problem well before the pandemic arrived. Data from National Records of Scotland show that Scotland still has a lower life expectancy when compared not just with the rest of the UK but with countries across western Europe. That is quite damning, so I look forward to hearing what the minister says on that in her summing-up speech.

Although overall life expectancy remains low, there is also a huge gap in life expectancy between the most deprived and the least deprived areas of the country. For men, that gap is about 13 years, and for women it is 10 and a half years. Those are worrying trends, and the gaps continues to widen.

There are also public health issues in relation to smoking, alcohol and cancer rates. Those all play a part in the situation. Mental health and loneliness are also significant problems in Scotland, with more than half of older people saying that they sometimes feel lonely. It is also estimated that there is at least one chronically lonely person on every street in Scotland. That represents a crisis.

Given that more than 50,000 Scottish pensioners live in relative poverty, it is important that the Scottish Government considers what older people are dealing with when it comes to expansion of its social security programme. Older people are more likely to have higher levels of disability, but a significant percentage are not claiming the disability benefits that they might be entitled to. We cannot allow older people to be left behind because they are not receiving the support, including financial support, that they require.

The Scottish Government needs to do more to address the matter. The Scottish Government must also engage with older people and stakeholders, including Age Scotland, as it develops its benefits take-up strategy.

The waiting lists that older people now face in the national health service are at tipping point, and the situation is spiralling out of control across many health board areas. The new health secretary should scrap his predecessor’s failed recovery plan and bring in measures to get waiting times back on track. That is vitally important.

Given all the problems that we have, the Scottish Government must send a clear message that it needs older people, and they should be seen as a key priority, going forward. The First Minister set out many priorities yesterday, but he did not specifically mention anything about our ageing population and older people. We used to have a dedicated minister for older people. That role has been incorporated into other remits, which is something that I feel should not have happened and is a fault and flaw within the new Government set-up.

That is not to mention the fact that comments have previously been made by a member of the Government suggesting that the number of older people who have passed away since 2014 would lead to a “gain” for independence. That is an astonishing comment for anyone to make about older individuals in our community. After such comments, it is perhaps not surprising that research by Age Scotland has found that only 21 per cent of over-50s in Scotland feel valued by society.

Although the study is a work in progress, it is already clear that its findings will be increasingly important in the years to come. The University of Stirling and its partners, including the universities of Edinburgh and Strathclyde, should be commended for the work that they have done so far. Scotland could truly be a great country in which to grow old and the findings of the study could be key to making that vision a reality, but there must be support and understanding from the Government. It is clear that further action from the Scottish Government is needed in this area and I hope that members from across the chamber will join me in pushing for that.

Older people are important and valued, and the Scottish Government must support older people and treat them with the respect that they deserve. They are an asset to our communities and constituencies, not a liability to Scotland and its future.

I remind members who intend to speak in the debate to ensure that they have pressed their request-to-speak buttons.

17:32  

I congratulate Alexander Stewart on securing the debate and congratulate the University of Stirling, which has a proven track record in respect of issues regarding the elderly.

I declare an interest, having entered Parliament in 1999, when I was already—according to the definition of ageing—elderly, although I was only 55. I am now on track to be 79—

No!

—too soon for my liking. Where did all those decades go? Thank you, Mr Whittle. The first comment that I will make is that not only are we—the “aged”—all individuals, but we represent a substantial age range, spanning five decades, so one cannot generalise.

I know that the challenges of ageing are not only physical but are, as the motion states, cognitive and social. I would expand that list to include the isolation and loneliness that were referred to by Alexander Stewart, who is very young. We have the research, but what can we, as politicians and individuals, do?

Older people are generally—I do mean generally—reasonably well catered for in respect of healthcare, for example with regular vaccinations, but it is when we are unable to care for ourselves that we are vulnerable, especially if we do not have savings or a decent pension.

That is why reform of the care sector and support for its workforce must be priorities. Too many people languish in hospital when aids and adaptations to their homes, care support at home, or access to a care home would not only free up hospital beds and the staff who service them, but keep people hale and hearty. Mental and physical wellbeing can soon disintegrate when a person is stuck in a bed far from the home where they should be. The creation of integration joint boards was a first step, but we need cohesion between the national health service and the care sector.

There is also the plague of isolation and loneliness. There are folk whose trip to the local shop or supermarket is the only social interaction that they have. Travelling on the bus with their pass is a bonus; it might be their only social life. The phone might be silent unless there is a cold call, and the front door remains locked, even in daytime, because there is no one coming to visit. Many people will not admit that they are lonely or that they have only the television or radio for companionship.

Retirement need not be absolute. For some people, continuing to work either whole time or part time, if that is compatible with the demands of the job, is a choice. I note that, with the diminishing workforce, many elderly people are returning to work, but doing so should be their choice and should not be done to prop up a poor state pension, for instance. Some 40 per cent of people who are entitled to pension credit, which is a UK benefit, do not claim it, and that percentage has remained unchanged during my entire time in Parliament.

For many people, especially very elderly people, there is a sense of being invisible and of melting into the background. Confidence erodes, as does the person’s sense of self-worth and their value. It need not be like that, however. In society, older people are too often regarded as a burden; they are patronised and they are not given the respect that age has earned them. I can report that age discrimination is alive and well, even in this building. It should be remembered that we were young once, too. We recognise the path that the young are treading, because we trod it before them. Perhaps only with age, however, do we appreciate time, because it is not on our side.

Other cultures value their elders, and we should do more of that in Scotland. I assure members that I will ensure that the Scottish Government does not ignore us.

17:36  

I am grateful to my colleague Alexander Stewart for bringing this important matter to the chamber for debate. He has worked incredibly hard to provide a voice for older people in the Scottish Parliament—although his youthful complexion makes it hard for some of us to believe. The same goes for my constituency neighbour, Christine Grahame.

Disappointingly, I struggle to recall the last time we were able to debate matters relating to older people in the chamber. There is no question but that the issue of healthy ageing is a key challenge facing us in Scotland today, yet, short of our holding a debate on the matter, the First Minister failed to mention our ageing population in his statement on Scotland’s priorities yesterday. Older people will be frustrated by that and by the fact that the Scottish Government has dropped the ministerial portfolio for older people. The Scottish National Party might have dropped that portfolio, but the shadow ministerial team and Alexander Stewart have no such plans to drop this important subject.

This valued group of people have been subject to a catalogue of let-downs—which Alexander Stewart has already alluded to—especially lower life expectancy in deprived areas. We can and must do better. In this context, doing better means examining the evidence that is available to us in order to drive change. I reference the University of Stirling’s Healthy Ageing in Scotland study, which will provide us with the opportunity to do that—to use the evidence to good effect. That is by no means the only source of evidence that we can use to drive change for Scotland’s ageing population. We cannot hope to cope with the demands of an ageing population without utilising the findings of that study and the work done by other nations to develop best practice.

One example of where that is being done very well is in my constituency in the Scottish Borders. Earlier this year, Scottish Borders Council endorsed plans to build a Dutch-style care village. That scheme is very much part of a shake-up of care provision in the region, and it is a good demonstration of proactive work by the local authority to consider evidence-based practices that can make a real difference for older people by encouraging healthy ageing and combating social isolation.

As Christine Grahame has quite rightly pointed out, social isolation is one of the main issues relating to poor health outcomes. I completely agree that we should be combating that, particularly through initiatives such as the Dutch-style retirement village. We want to move away from institutionalised care and place residents in neighbourhoods, which are closer to broader society. Similar schemes in the Netherlands have found that that helps to tackle loneliness and improves outdoor access, which are key factors in healthy ageing.

I am delighted that our Conservative-run administration in the Borders is leading the way in finding an innovative solution to cope with the challenges of an ageing population and social isolation. I encourage the Scottish Government to take note of that and to join the Borders Conservatives in thinking outside of the box when it comes to dealing with such challenges.

Having this discussion in Parliament is important. In dispensing with the ministerial portfolio for older people, the Scottish Government has sent a deeply concerning message. However, as long as we have the opportunity to speak up for older people and we continue to do that, we can be their voice in this Parliament.

17:41  

I, too, thank Alexander Stewart for bringing this important debate to the chamber. I also thank all the members who have spoken in it for highlighting how important it is that we have debates to address issues relating to the older population.

On behalf of Scottish Labour, I welcome the Healthy Ageing in Scotland study, led by the University of Stirling, and I put on the record my thanks to the team who will start this extremely important work. The study is the first of its kind and, although it will look at many different factors, including health, social and economic circumstances, the main aim of the team of researchers is a simple but critical one: to improve the health and wellbeing of Scotland’s older people by fully understanding their lives.

The health of our population must be the priority for any Parliament and any Government. After the past few years, that is clearer than ever before. However, as other members have stated, being healthy does not just mean being physically healthy; it means being mentally, socially and economically healthy, too. Each of those crucial aspects of life plays a role in determining the health and outcomes of an individual, a family or a population.

The motion correctly notes that our older population is growing and that people are living longer, but it is also right to state that significant and divisive income inequality exists in our society today. I absolutely agree with much of the content of Alexander Stewart’s motion and speech. I know that he has been a champion of older people. However, I have to say—because it is important—that his party’s policies are responsible for much of that division. We need a whole change in approach with regard to improving pay, closing pay gaps and supporting the lowest paid in order to improve health and wellbeing outcomes later in life. It starts early in life and it continues; people start an unhealthy life and then live an unhealthy life. A lot of that is linked to the austerity that we see in this country.

It is important that we touch on health inequalities right now. Health inequalities are one of the greatest strains in our society—members will not be surprised to hear me say that, as I say it often. We need far greater action than we have had. The First Minister was right to focus on tackling poverty yesterday. However, people from deprived areas in our country are less likely to attend screening appointments. That remains a stark gap and an avoidable one. It is not always about income; it is about how we ensure that those people can attend vital screening appointments.

We know that health inequality exists from birth, but we also know that it continues to negatively impact people throughout their lives and can determine outcomes in later life. As the project embarks on the study, it will be interesting to see whether we, as parliamentarians, can act more decisively and effectively to address the issues that have led to the study being undertaken.

A staple of any healthy, progressive, modern nation should be the ability of its citizens to age healthily and to grow old with dignity. I hope that the study will allow improvements to be made that will positively impact the health and wellbeing of the older population.

Many of the challenges that are faced by our older people in Scotland today have been exacerbated by poor Government decisions. In some cases, there has been Government inaction. We know that we need to improve the health and wellbeing of our elderly population—we need to do so urgently and to be quite radical about it.

Healthy ageing should be a priority. Once again, I thank Alexander Stewart for lodging the motion, and I thank all members who have contributed to the debate.

17:45  

It had been my intention to come along today and just listen to what was said, given my advancing years according to what “old” means. However, I happened to take part today in a webinar on a university report on the life expectancy of elite sportspeople. It turned into more of a discussion around early years and attitude, and members will be pleased to hear that I can expect to live an extra five years according to that report.

More important than that, the sportsmen and women who were on that call discussed the reason that we would live longer, which is not necessarily the excessive physical activity that we did in our younger years but the attitude that is ingrained into a sportsperson’s mind. We know that being physically active has a positive influence on our life expectancy, so it is not a big leap to think that those of us who did that to excess will benefit from it. During the discussion, we talked about how being active early in life has a positive effect on life expectancy and living well in our later years.

To follow on from the previous discussion, we have health inequality in our society that is yet to be tackled, in my view. In the seven years that I have been in Parliament, I have talked about the obesity crisis, smoking and alcohol, our mental health crisis, musculoskeletal conditions, type 2 diabetes and preventable conditions such as 40 per cent of all cancers. A lot of those issues are being discussed today. We tackle them in one of two ways: either we decide that we are going to shovel more and more of our resources into treatment of those conditions or we bite the bullet and take a long-term look at how we prevent those conditions in the first place and have fewer people seeking medical treatment.

I am highlighting the need to make our youngsters active so that, in 70 years’ time, they will be living a long and active life. Parliamentarians struggle to look further than five years ahead, and I am talking about looking six or seven decades ahead and laying the groundwork for that. If we do that now, it will take four or five years to see any benefit from the policy, and it will take decades for it to bear the full fruit, with an elderly population living long, active and healthy lives.

As Carol Mochan said, there is inequality of opportunity. In order to encourage our pre-schoolers to be physically active, we must give them that opportunity. If we tackle inequality of opportunity, the outcomes in later life will be much better than they currently are. It should be noted—I think that it was said earlier—that, in some areas of Scotland, a person is near the end of their life expectancy if they are 50. That is an utter disgrace in a country such as ours.

As I said, it was not my intention to speak, but I wanted to say that, in order for people to live well in later life, we must encourage our youngsters to live well.

17:50  

I thank Alexander Stewart for lodging the motion for the debate. Like most of my colleagues who have participated in the debate, I am included in the age range for the study. Like Brian Whittle, I was slightly taken aback that it related to people in their 50s. I recognise Christine Grahame’s comments about joining the Parliament in her 50s. I have listened to the contributions carefully and I thank everyone for engaging in this important debate.

I welcome the data that the University of Stirling-led Healthy Ageing In Scotland—HAGIS—study provides on Scotland’s 50-plus population. As Alexander Stewart mentioned, the Scottish population is ageing. In 2020, an estimated 1 million Scotland residents were aged 65 or older. By 2040, that figure will rise to an estimated 1.4 million residents. It is clear that Scotland must adapt to our increasingly older population and ensure that all older people are afforded the opportunity to age well and be resilient. I confirm that my colleague Emma Roddick has clear responsibility for diversity, inclusion and equalities, including older people.

The Scottish Government wants to make sure that all our policies on ageing are informed by evidence, and we regularly review the evidence that is available. For example, the Scottish Government is currently co-designing GIRFE—getting it right for everyone—which will form the future practice model of all health and social care professionals and will shape the future design and delivery of services, including those for older people and frailty.

The Scottish Government consulted on a health and social care strategy for older people in 2022. The Government recognises that older people are significantly more likely than any other age group to be living with dementia or to be unpaid carers for someone who is living with dementia.

In March, I was pleased to attend a meeting centre’s introduction to dementia event, where I learned about the work that it is doing to support and give confidence to people with dementia and their families. I made the mistake of using the term “dementia sufferers”—we need to change our outlook on dementia and the words that we use about people who are living with it.

In my previous life—this touches on Rachael Hamilton’s point about what we can learn from different communities—I managed the Museum of Islay Life, in my constituency. One of my strongest memories is of the additional stories and information about exhibits and photographs from the older members of the island’s community, some of whom had dementia. I could see the positive impact on them of contributing to the recording of Islay’s history.

Both of my grans lived with dementia, so I am very pleased that the Scottish Government is currently developing a new dementia strategy for Scotland, which will reflect on the challenges that those communities face and build on the supports that matter to them. The Parliament welcomed efforts to develop the strategy and the core participation of people who have lived experience in its development during last month’s parliamentary debate on the topic. I look forward to the Scottish Government publishing the strategy at the end of May.

Through our new palliative and end-of-life care strategy, we are prioritising work on anticipatory care plans and looking at what can be done to promote their use. Those plans will enable people to have conversations with health and care professionals about what matters to them and to record and share those conversations as a plan, so that the care and support that they subsequently receive, if and when their health changes or deteriorates, honours that plan.

Care homes are where people live—Christine Grahame talked about the importance of recognising that. People call those places home, so they should expect the same level of involvement, choice and support for their health and wellbeing as they would if they were living elsewhere in the community. However, we also need to recognise that, with the demographics of people living in care homes having changed over the past 10 to 15 years, the needs of those who reside in them are evolving, too. Many people are living with increasingly complex health and care needs.

“My Health - My Care - My Home” is a blueprint for improvement in care homes and makes a series of recommendations to reduce the inequalities around access to wraparound care. It provides direction and a vision to provide high-quality, personalised care that is proactive, consistent, safe and meaningful. Unfortunately, we have seen social isolation and loneliness being made worse by the cost of living crisis. As part of our emergency response to the cost crisis, earlier this year, the Scottish Government invested £971,000 into providing support to community organisations working to tackle social isolation and loneliness. The £3.8 million social isolation and loneliness fund was launched on 8 March 2023, and it will run to July 2026. That new Scottish Government funding will provide significant longer-term support for organisations and projects working on the ground to tackle social isolation and loneliness in our communities across Scotland, which Carol Mochan highlighted as well.

Over the two years since 2021, we have provided £36 million to the communities, mental health and wellbeing fund to support the mental health and wellbeing of individuals, particularly those who are at most risk, including older people, funding projects such as the concrete garden project in Possilpark, which provides a space where people can meet, eat, learn new skills and garden. Local projects such as that, which are focused on local solutions and supporting local communities, are key to helping people’s wellbeing and reducing social isolation.

However, it remains a sad reality that health, quality of life and even life expectancy, which Alexander Stewart mentioned, can vary significantly across our communities. Those inequalities are driven by differences in income, wealth and power. By addressing them, we can make Scotland a healthier and fairer place to live. That is why our public health initiatives are complemented by wide-ranging action to reduce poverty and mitigate the impact of the rise in the cost of living. In a country as energy rich as Scotland, we should not have people living in fuel poverty.

However, with the UK Government rolling back its already inadequate response to the energy cost crisis, we know that many people will be struggling to keep their homes warm. Despite key policy levers such as the regulation of energy markets remaining under the UK Government’s control, we are doing everything in our power to help those who are worst affected. Most recently, the First Minister announced increased support for households with energy costs, with up to £30 million available through the fuel insecurity fund—a tripling of the fund from this time last year. With that additional funding, we will be able to help thousands more people to stay warm in their homes. We want to ensure that all our policies on ageing are informed by evidence, and, as I said before, we regularly review that evidence.

I hope that I have set out clearly the Scottish Government’s commitment to older people and to healthy and dignified ageing and that I have shown that the Scottish Government believes that older people are a valued and respected part of our community.

Meeting closed at 17:57.