To preserve the NHS, we must limit the causes of poor health throughout people’s lives

People are living longer than ever before, and this is changing the demographics of society. This is not an insurmountable problem, nor is it one unique to our country. But it will require us to innovate and adapt how healthcare is provided to ensure the NHS continues to deliver for an ageing population.

Living for longer should be a prospect that fills us all with joy and optimism. More opportunities to spend time with family, more opportunities for new experiences. But the benefits of a longer life are not shared equally.

If you are poor, your prospects for later life look very different than for someone with untold riches. To address these inequalities and make the NHS truly sustainable, we need to look beyond the health system to the causes of poor health in our everyday lives – such as low quality housing and a lack of access to good work.

British people are living longer, but we shouldn’t be complacent or take continual improvements in health for granted. Life expectancy in this country has stalled over the last decade.

Between 2001/03 and 2011/13, life expectancy at birth increased by 3.1 years for men and by 2.4 years for women. That increase slowed considerably between 2011/13 and 2017/19 and has declined in the period between 2017/19 and 2018/20.

Within 20 years, one in four of the country’s population will be aged 65+ so there is a need for new approach, innovative thinking and much greater focus on how to adapt to these changing demographics.

And there will be little to cheer if those additional years of life are spent in poor health. A woman aged 65 today can expect to spend less than half (47%) of her remaining years in good health while a girl born today can expect to live more than a quarter (26.7%) of her whole life with illness and disability.

A priority for any government should be ensuring that the UK is the best place in the world to grow old in and that includes taking steps to ensure more people remain in good health as they enter later life. That requires ensuring that everybody has the same opportunities to achieve good work, financial security, a decent home, and to develop and maintain connections to family, friends and a supportive wider community.

Men in the most deprived areas of England will die on average almost ten years sooner than their peers living in the least deprived areas. When the poorest people get to the age of 65, they live twice as many years with disability and illness as the wealthiest.

Such a vast gulf between the haves and the have-nots is clearly unacceptable. Halving the health inequality gap is a good ambition, but it will not be easy. Election promises are like air dry clay pots. Easy to make, even easier to break.

It will require concerted action from across government to address the behaviours that often lead to illness and disability in mid to later life and to tackle the wider determinants of health across people’s lives.

And if government is going to make any progress on reducing the gaps in life expectancy and healthy life expectancy in the short five-year timespan of a parliament, then any work on health inequalities must include a strong focus on the older population.

Ensuring we have better quality housing is a public healthcare issue. Poor quality housing costs the NHS £1.4 billion every year largely through excessively cold living conditions and hazards that cause people to fall and injure themselves. The Centre for Ageing better has long highlighted the impact of non-decent homes including our 2020 report with the King’s Fund which detailed how 4.3 million non-decent homes in England were putting the health and wellbeing of around 10 million inhabitants at risk.

There are a number of meaningful steps that can be taken in this parliament, or early in the next, that can help deliver better quality homes. These include bringing in minimum accessibility standards to new homes to ensure the houses we build tomorrow are suitable for all.

We also want to see the decent homes standard introduced into the private rental sector – currently one in three homes in the sector do not meet this level.

We are encouraged by the ambitions Labour have for a nationwide retrofitting programme. This could bring not only benefits in terms of improved health but also in cost savings for individuals and carbon savings for the planet. But we really want to see more detail and assurances that such a programme will also help people to make their homes safer and more accessible.

Longer lives mean longer working lives. But longer working lives may not be possible if our later years are spent in poor health or if work does not allow the flexibility to manage our health.

We have seen some progress on employees’ rights which could help some to stay in work for longer. The new Carers Leave Bill, achieved thanks to cross-party support for a Private Members Bill, gives greater flexibility for carers to balance care duties and employment.

But we also need the next government to bring forward a more comprehensive employment support bill that protects employees in balancing their job, caring commitments, and personal health appointments. This should include paid carer’s leave and the day one right for all workers to request flexible working.

The NHS is currently being propped up by the stoic dedication of unpaid carers whose economic contribution to the country is almost equal to the costs of funding our national health service. As our ageing population grows and we lead longer lives, so too will carers themselves and so it is critical they are given the support they need to continue this largely unheralded public service.

All this will require joined-up thinking across government departments, that considers the needs of both today’s older people, and future generations.

This is why we recently launched a campaign with Independent Age, Age UK and the National Pensioners Convention, along with 80 national organisations, calling for the government to appoint a Commissioner for Older People and Ageing for England.

A Commissioner for Older People and Ageing for England would act as an independent champion for older people and ensure that policymaking takes into account the needs of our ageing population. And help ensure that the promises to the ageing population made now and during the election campaign are delivered.