“Simple steps to live longer” was the front page headline of the Daily Express yesterday. “When it’s time to go, let me go, with a nice glass of whisky and a pleasing pill,” pleaded Margaret Drabble in The Guardian, arguing that medicine is artificially prolonging life, leading to misery, dependency, dementia and loss of dignity in people’s final years.

‘An ageing society has to address ethical issues about a person’s right to control the timing and manner of their own death’

You can hardly watch or read news with out being told we will live longer, work longer and have to survive on a lower pension. Politicians blame the increased pressure on hospitals on elderly people blocking beds and an unaffordable drugs bill on expensive life prolonging drugs.

Commentators have accused older people of being selfish in taking a disproportionate share of society’s scarce resources and misusing their voting power for self-interest. You can’t blame doctors and health professionals for keeping us alive, but surely we can all agree old age should be enjoyed rather than endured?

Role of commissioners

An ageing society has to address ethical issues about a person’s right to control the timing and manner of their own death; quality of life is a factor in extending life and life expectancy should not differ dramatically depending where you live or your income.

So which of these challenges will clinical commissioning groups be able to address?

Not ethical issues; these need to be addressed by Parliament, informed by medical professions and taking account of changing public opinion. Not how much the public purse funds the needs of older people or to what extent people will be expected to fund their own care in old age either; this will be decided by voters.

Quality of life

Commissioners are expected to shift the funding away from hospitals and into primary and community services, which should benefit older people, especially if they are linked to the integration of health and social care. But that has been an aspiration for a long time.

‘In common with the rest of the Western world, the UK has assumed that extending life expectancy was all part of progress’

Many commissioners have set themselves the target of addressing health inequality locally but they need the Department of Health not to undermine this by the way it operates the national formula for funding. Commissioning is being promoted as the vehicle for transforming the NHS but the future of the service will be determined by our response to issues of life expectancy and quality of life.

In common with the rest of the Western world, the UK has assumed that extending life expectancy was all part of progress. It turns out you can have too much of a good thing.

Topics