Healthy Ageing: Citizens needs and expectation The challenge for society CONCLUSIONS Bad Gastein, October 2003

THE CHALLENGE How can a process of mutual learning and an exchange of experiences and best practice models – for healthy ageing - best be initiated and continued at the European level? Each speaker asked to make 2-3 recommendations for future political action.

l The nature of the challenge l The research agenda l The policy agenda & recommendations l Potential & limitations of European cooperation

The nature of the challenge (1) l The demographic revolution – ageing population/declining birthrate/decreasing mortality/ increases in age-related diseases,with consequent impact on societal costs. l Not all “doom and gloom”: –Living longer does not necessarily mean higher healthcare costs to the individual –Substantial & growing decline in elderly disability in US l Uncertainly about trends and consequent the cost projections. l Need to consider “who cares” (professionals/carers), “who pays” (funding system/public-private mix/social care/cash benefits/buyers power) & “who decides” (fragmentation/ consumer choice

The nature of the challenge (2) l Need to prepare NOW to fund public health, social care, pensions in 2050, but… l Widespread resistance to implement the reforms that are necessary NOW for THEN l Recognise the role of informal carers (often themselves older women) and the diminishing pool of informal carers. l Europe has lowest 65+ labour force participation in world, and “useful lives” promote wellbeing. l Ageing is not a disease, but a multidimensional, complex process, and should not be medicalised.

The research agenda l Serious knowledge gaps,especially in Europe. l Why are people retiring so early in some EU Member States? l Why the variations in disability prevalence in Europe? l Disaggregate (EU) data by gender – healthcare needs are not the same. l Ageing is a complex phenomenon requiring interdisciplinary research. l Need for longitudinal data sets to inform research l Involve citizens/public in ageing research

l Grey power. Politicians had better take notice! l Not only focusing on healthcare – interconnectedness of housing, income levels, pensions, employment policies…requiring integrated care! l Wise ageing policies should prepare for a worse demographic future than they currently predict. l Accelerate structural reforms to prepare for accelerated growth in numbers. l Greater investment in research – evidence based, multidisciplinary, patient-centred; l Policies and public health campaigns for health promotion and disease prevention for younger adults; The policy agenda and recommendations (1)

l Provide incentives to encourage continued participation in workforce; l Primary care programmes for quality care in the community, incl. education and training of health care team. l Safeguard qualifications of long term and social care staff l Explore mobility of professional and informal carers from accession countries; l Explore impact of “internal market” for long-term care on principles of accessibility, quality & financial sustainability; l Explore empowerment of old, vulnerable people as consumers. The policy agenda and recommendations (2)

Potential for European cooperation (Open method of cooperation) l Surprising degree of support for OMC – ranging from enthusiasm from Hungary and the patients’ organisation to a rather more cautious welcome from the UK. l Plea for flexibility in OMC structures, especially because of complexity of issues related to older people –regionalisation, social care, informal carers, housing, education. l Involvement of industry, which has a European/global perspective. l Researcher: OMC won’t work without data. Can’t wait for perfect indicators, so lets start with objectives, then develop indicators. If we want to find best examples, we have to name countries….but not shame them! We need to put issues and differences on the table if we are to learn. l Involve citizens and patients.

Healthy Ageing: Citizens needs and expectation The challenge for Society CONCLUSIONS Bad Gastein, October 2003