Age is a protected characteristic in the Equality and Human Rights Act, but sadly, it does not have the same status as other protected characteristics. Ageism is alive and well in society and the health and care system. Not only does this manifest itself in the casual use of ageist language, but it is also endemic in the way in which the health and care system responds to individuals who have support needs.
In relation to language, I was given some very good advice by the late Baroness Greengross (the first Equality Commissioner on Age), who told me that if you want to know if any language is unacceptable, flip the category. If it would not be acceptable to replace age with black, gay, or disabled, then it is not acceptable to use this language. Yet I am often seeing people casually using ageist language such as “old fool” which would never be acceptable if replaced old with black, gay or disabled.
There is clearly a hierarchy of oppressions, and age is very much at the bottom of the list. This is particularly evident in the health and care system and how social care services are commissioned, regulated, and funded. Ageism is manifested in the way in which local authorities expect personalised care plans but commission older people’s services with strict financial limits, and care rates are seldom varied based on individual needs. There are very few authorities that have block commissioning for younger adults.
It is also interesting to note the variation in the expectations in people’s care packages. I have seen care packages for younger adults that have amounted to well in excess of £3000 a week, and yet I have never seen this being commissioned for an older person. It is also noticeable in care plans for younger people, which are often filled with wonderful, meaningful activities. I recently saw a great care plan for a younger person, which had them being taken once a fortnight 40 miles with a chaperone to spend the afternoon with their sister. I have never seen this in a local authority-funded care package for an older person, though it is arguable that many older people would get significantly improved well-being from being able to connect with their family and friends.
The Care Quality Commission also manifests this ageism in regulating services, particularly in its mantra that small is beautiful in younger people’s services, which does not apply to the older people sector. If it’s not appropriate for young people with learning disabilities to live in communities of more than five why is this not applied to older peoples services?
Ageism is being ignored right across the system, by the NHS (I have never heard of a child being left on a trolley in the corridor for 14 hours) by local authorities, and by the Equality and Human Rights Commission, who have done absolutely nothing to raise this issue and call the Government to account. Politicians delight in creating laws, and it’s time they were forced to abide by them.
