MED­I­CAL CHIEF: OUR OLD-AGE HEALTH CRI­SIS

New Chief Med­i­cal Of­fi­cer warns of surge in el­derly pop­u­la­tion ++ Re­veals ru­ral ar­eas strug­gling to cope ++ In­sists only a health revo­lu­tion can avert emer­gency

Daily Mail - - Front Page - By So­phie Bor­land Health Edi­tor

THE NHS risks be­ing over­whelmed by an old-age health cri­sis, the new Chief Med­i­cal Of­fi­cer warns to­day.

Chris Whitty says dras­tic ac­tion is needed to cope with a surge in the num­ber of pa­tients aged over 65.

He points out that coun­try­side dis­tricts and coastal towns with older pop­u­la­tions are

of­ten poorly served by GPs, hospi­tal clin­ics, am­bu­lances and out-of-hours providers.

In his first in­ter­view since be­com­ing Eng­land’s Chief Med­i­cal Of­fi­cer in Oc­to­ber, Pro­fes­sor Whitty pro­poses a se­ries of rad­i­cal so­lu­tions to our age­ing cri­sis. Speak­ing to the Mail he ex­plains how:

• Doc­tors’ train­ing will be re­formed so they are able to bet­ter care for pa­tients with sev­eral chronic con­di­tions;

• Med­i­cal schools will be lo­cated in ru­ral and coastal ar­eas to en­sure more doc­tors serve these age­ing com­mu­ni­ties;

• Cer­vi­cal can­cer and many liver can­cers will be erad­i­cated in 60 years and other types will be much eas­ier to treat;

• Min­is­ters must avoid let­ting big to­bacco firms lure chil­dren on to e-cig­a­rettes;

• Trendy cannabis prod­ucts on sale on the high street may be un­safe.

Pro­fes­sor Whitty, 53, is the Gov­ern­ment’s top health ad­viser and his brief stretches from plan­ning the re­sponse to coro­n­avirus to draw­ing up key med­i­cal poli­cies. But one

‘This is pre­dictable and it’s solv­able’

of his most press­ing con­cerns is how to meet the needs of the grow­ing num­bers of older pa­tients with mul­ti­ple ill­nesses.

Eigh­teen per cent of the pop­u­la­tion is over 65 but by 2038 this fig­ure is ex­pected to reach 24 per cent, nearly one in four.

It is pre­dicted to be 40 per cent in North Nor­folk by then and 37 per cent in the Lake Dis­trict.

Other age­ing hotspots are ex­pected to be Rother in East Sus­sex (41 per cent) and East Lind­sey in Lin­colnshire (37 per cent).

Pro­fes­sor Whitty says: ‘The age­ing of the pop­u­la­tion of ru­ral ar­eas will oc­cur much faster and there will be a much higher con­cen­tra­tion of peo­ple who are older who there­fore have more health needs in the ru­ral ar­eas.

‘We have to think about this both for now and also ac­cord­ingly for the fu­ture, this is a fu­ture is­sue.

‘If we did noth­ing on this we will get to a sit­u­a­tion where the bur­den of dis­ease for the coun­try – the num­ber of peo­ple who are ac­tu­ally suf­fer­ing from lots of long-term med­i­cal con­di­tions – will go up and ser­vice de­liv­ery will stay where it is. The gap be­tween what peo­ple need and what peo­ple get will widen.

‘We have un­der-ap­pre­ci­ated how much in the fu­ture this is go­ing to be an is­sue. This is pre­dictable and it’s solv­able, pro­vided we take a long run at it.’

Pro­fes­sor Whitty, who took over the role from Dame Sally Davies in Oc­to­ber, stresses that the in­crease in over-65s will re­sult in many more pa­tients suf­fer­ing from mul­ti­ple long-term con­di­tions.

These could in­clude de­men­tia, can­cer, di­a­betes, cataracts, heart dis­ease and os­teo­poro­sis – bone thin­ning – and some of these dis­eases will ag­gra­vate one an­other. Pa­tients can end up hav­ing five or six dif­fer­ent hospi­tal out­pa­tient clin­ics for each ill­ness which Pro­fes­sor Whitty says is ‘nei­ther good medicine, nor is it con­ve­nient for pa­tients’. To end this, he wants to re­form doc­tors’ train­ing so they are more gen­er­al­ist than spe­cial­ist. He has been dis­cussing the pro­pos­als with the Royal

Col­lege of Physi­cians, the Royal Col­lege of Sur­geons, the Academy of Med­i­cal Royal Col­leges as well as NHS Eng­land.

He says: ‘We’re talk­ing par­tic­u­larly about hospi­tal doc­tors, we need to make sure they re­tain their gen­er­al­ist skills.’

Pro­fes­sor Whitty also wants med­i­cal schools to be set up in some of the ru­ral and coastal lo­ca­tions where pop­u­la­tions are age­ing fastest.

He hopes that this will even­tu­ally re­sult in more doc­tors – hospi­tal con­sul­tants and GPs – prac­tis­ing in the ar­eas of great­est need.

‘One of the things we need to look at is how we can in­cen­tivise GPs and other doc­tors to want to work in these ar­eas both for cur­rent and also fu­ture need,’ he adds.

‘There’s just a ser­vice de­liv­ery chal­lenge that we need to think about and work out what meth­ods we can use to ad­dress that. Some ar­eas are more re­mote than oth­ers – pro­vid­ing ser­vices in the Lake Dis­trict will be more prob­lem­atic just be­cause of the ge­og­ra­phy.

‘It’s suf­fi­ciently pre­dictable and suf­fi­ciently far in the fu­ture that if we start do­ing things now, we can start to ad­dress it. If we wait un­til the prob­lem has hit us, which it un­doubt­edly will, it will be a lot harder to sort out.’

Pro­fes­sor Whitty

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