Hansard

That was a nice, cheery speech from the Minister for Social Justice. She is obviously demob happy, and I do not intend to lower the tone too much in my speech.

There are 944,000 people of pensionable age in Scotland—about 19 per cent of the total estimated Scottish population. By 2026, there will be about 1.3 million people of pensionable age, or approximately 27 per cent of the total Scottish population. Life expectancy stands at 72.9 years for men and 78.2 years for women. As was recently reported, those figures are, sadly, among the lowest in western Europe.

Despite the advances that have been made, of the 641 mainland parliamentary constituencies in Britain, 10 of the 20 poorest are in Glasgow, so there are certain areas of health inequality still to be addressed. That will take not just years but generations. A majority of people of pensionable age are female, because of women's longer life expectancy. As a result, many of them will live alone and will consequently suffer high morbidity rates.

We would all agree that many of the attitudes held by some people in our society towards older people must change. Jess Barrow, head of policy at Age Concern Scotland, said:

"Some of the ways we treat old people we just would not accept for any other section of society."

Unfortunately, the European Union is not due to implement anti-ageism legislation until 2006. A recent King's Fund guide found that ageism is difficult to identify because people are not used to having to recognise it, given the lack of anti-discrimination legislation that is related to age, unlike that which exists for race or gender for example. However, more than half of Scots believe that

"this country treats older people as if they are on the scrap-heap"—

and almost half believe that

"old people in this country are considered to be a burden on society."

Ageism, or discrimination against older people, may not consist of deliberate sentiments against older persons, but may involve them being patronised through ignorance of their need to be treated as fairly as everyone else. The Executive has set up an equalities strategy, the older people's unit and the older people's consultative forum, and it is great to see the forum's chair, the esteemed Frank McAveety, here today. However, more must be done to reverse the deep-rooted social acceptance of patronising and discriminatory behaviour towards older people so that we treat them with the respect that they deserve.

Age discrimination occurs because a low value is associated with older people's lives. The idea exists that older people had their chance and that their quality of life, as an older person, is not worth saving as much as that of a younger person. Some people believe that older people are a burden to others, such as their family or friends or the NHS.

Many older people face not only discrimination as a result of their age. They may also suffer from multiple problems due to age and disability—indeed, they may face discrimination on the ground of disability. As Ros Levenson, author of "Auditing Age Discrimination: A practical approach to promoting equality in health and social care" stated:

"Tackling age discrimination is too low on the agenda for many health and social care organisations. But ageism is a serious equality issue."

I am pleased that the minister touched on that matter.

Of course, the majority of older people are fit and healthy and should not be thought of merely as a burden on the NHS. Health is one area of older people's lives in which they are likely to encounter both positive discrimination—for example, exemption from prescription charges—and negative discrimination, such as age limits for transplant services in the NHS. Executive targets for reducing the incidence of cancer, heart disease and stroke apply only to those below the age of 75. In the words of Maureen O'Neill, the director of Age Concern Scotland, that approach will "entrench these inequalities". My colleague Kay Ullrich will explore the impact of health care on elderly people in greater detail, as it is an important issue for older people.

Some initiatives are proactive, but they will not make a difference until other problems in the care of older people are rectified. One survey—"Hard Times: A study of pensioner poverty" contained the following message from an older person:

"Thank you very much for my free TV licence but I would really like to have my cataracts done so that I could see the television."

A quarter of suicides occur in older people, although they make up less than a quarter of the general population. Ninety per cent of those concerned had serious depression and most visited their doctor in the three months prior to their death. That may indicate that general practitioners are not taking the mental health needs of older people seriously. I encountered that problem, especially in the treatment of depression, in a previous life. When older people who are suffering from depression visit a doctor, they are often given older drugs such as tricyclic antidepressants, which can dope and slow down older people, making them more liable to falls and so on. Younger people, who tend to work or have families, receive drugs such as selective serotonin reuptake inhibitors, which cost 20 times more per day than the drugs that are given to older people. I encountered that apartheid in primary health care on many occasions before I was elected to the Parliament, which may want to examine that issue.

Long-stay hospitals have closed in favour of treating older people in the community, and that is to be welcomed. Implementing the joint futures agenda to provide more seamless care between the NHS, local authorities and community and social care has reduced the number of delayed discharges. As the minister indicated, the Parliament has introduced free personal care for the elderly and the regulation of care services in Scotland. However, although welcoming the progress that free personal care is making in local authorities, a recent Age Concern Scotland report argued that there was a continuing need to publicise it and to provide clarity about the policy. The report found that there is a postcode lottery in available care places and that waiting times for care provision vary. Its authors were also very concerned about long-term funding.

Scottish Care, the Executive and the Convention of Scottish Local Authorities need to renegotiate funding for private care homes, before older people who require care become the innocent victims of the crisis in funding in community care. Their human rights may be breached. As Tessa Harding, head of policy at Help the Aged, states:

"Homes have to be closed with care … if the Human Rights Act is not to be breached … Where are these residents to go? There is already a major crisis in the care home sector and few areas have spare capacity."

Bedblocking remains a problem. Some 2,798 patients are awaiting hospital discharge, 239 of whom have waited more than 12 months. If the Executive does not find it acceptable for people to wait more than 12 months to get into hospital, why is it acceptable for them to wait more than 12 months to get out? In addition, the number of people receiving a home-care service has declined since 1999 by 7,357, and the number of residential care places has fallen from 16,300 to 15,150, which is a decline of 1,150.

An issue in which many MSPs have been interested in the past few years is that of Scotland's carers. There are approximately 626,000 carers in Scotland and about one in six is over 65. Two thirds of carers look after elderly people. It is therefore vital that we take on board the considerations of older people and carers and end the opportunity gap for carers, older people and older carers.

Benefit provision for Scottish older people, which is reserved to Westminster, is necessary to reduce and prevent poverty. Two thirds of pensioner households do not claim state benefits—of course, some are not entitled to them—but an estimated 57 per cent require some form of state benefit. Unfortunately, almost a quarter of those who are eligible do not claim. Indeed, 50,000 pensioners who are entitled to the means-tested minimum income guarantee do not claim it. Each person who has not claimed it is really entitled to an average increase of £18 in their weekly income at present, which would raise their pension levels to more than £90 on average—that was the amount that Age Concern stated was necessary in 2001. The minimum that we can guarantee is an admission that the basic state pension is inadequate to live on. Pensioners might not collect benefits because there might be a stigma attached to claiming them among older people, but it is also likely that the process is time-consuming and confusing for some of our older people.