28 April 2008
The 2020 Summit was a unique opportunity for those of us who attended from Sydney University to provide real input into directions for government policy.
I was especially struck by the willingness that was shown to embrace research evidence-based policy, which bodes well for the future. I was also impressed by the extraordinary mix of people. Within my area, there were many of the top minds in the health field across the country and from a diverse range of backgrounds.
As National Convenor of the ARC/NHMRC Research Network in Ageing Well, I was prepared to put forward the case for the challenges and opportunities facing an ageing Australia. But rather than the health area becoming a debate among what could be seen to be competing interests, the debate took a more comprehensive life span approach to health. The Summit's first recommendation, was that we 'support the health of all Australians at all stages of life'.
My conviction is that how well we do later in life is critically determined by what happens in early and mid-life. Mid-life in particular is the turning point at which many people set trajectories for going upward or downward as they grow older
The Summit's third recommendation,that health policy should be focused on prevention, has a large and positive impact on older people and society in general. Research shows that prevention actually works and can improve the quality of life of older people, keeping them out of hospital, whereas the existing approach has largely considered older people in terms of care issues and the cost of being in hospital.
Indeed, I would like to shift the focus away from seeing aging as a burden to viewing ageing constructively as a major achievement. How we choose to manage ageing will have a major impact not just on older Australians but on all Australians. A productive generation of older people is good for the individuals concerned and for the economy as the whole, while a healthy generation of older people is again good for the individuals and for the entire health system. By investing in research we can find better ways to achieve both of these outcomes.
The most dramatic change in ageing is the increase in longevity of the average Australia. Three months has been added to the average lifespan for every year which has passed over the last several decades. We now need to bridge the seventeen year life expectancy gap between indigenous and non-indigenous Australians and the gap between the wealthy and the poor.
Yet ageing is about far more than length of life - it's about independence, dignity and comfort. For us to live healthy and rewarding lives into our old age we need to change our social institutions, re-evaluate our idea of retirement and thoroughly rethink how our health system works. The vast majority of us will never go into a nursing home. A real emphasis on community-based care and preventive care will help us to preserve our independence, dignity and comfort. These are the real pay-offs that come from investing in health care.
Healthcare needs to be "structured around the person rather than the provider". Here's an example of what this means. Rather than providing an expensive high-tech intervention a terminally ill older person may prefer to be given the appropriate palliative care which will provide comfort, dignity and support through to the end of life. In other words, decisions need to be made in context from a person-led perspective, instead of from the present provider-led perspective.
After having had time to digest the summit experience I am very positive about the process and the opportunity. Implementing findings is up to the government of the day, I'm now focused on the next step, helping Australians age well. We need a more thorough understanding of the ageing process and what actions can be taken to achieve positive outcomes for people of all ages. The interconnections between generations make getting this right important for all of us.
Hal Kendig is Research Professor in Health and Ageing at the Faculty of Health Sciences.
Contact: Jake O'Shaughnessy
Phone: +61 2 9351 4312 or 0421 617 861