This essay will examine an area of discrimination in health care and examine government policy post 1997 towards addressing or reinforcing it. Since early 90s, the government has been introducing range of policies to help tackle discrimination within society. Discrimination is a consists of acts, practices or policies that advantage one group over another because of specific characteristics, this can result in the unequal treatment of others, bases on credited or claimed characteristics such as age, ethnicity, gender, class, disability or sexual orientation. The law itself does not prevent discrimination from happening, but it does give people a course for action and potential sanctions including legal proceeding against the offenders .
Intergenerational conflict theory comes in mind, this theory discourses the concerns of the ageing population and the intergenerational conflict between young people who are working and the retired old regarding the perceived fairness of the distribution of welfare. The underlying assumption being that old people use more of the resources like health and social care. Take for example when you look at the hospital beds 6 out of 10 beds is taken by an old person as they live longer they develop different kind of illness that require them to stay in the hospital for treatment. Old people’s charity Age UK (2014) argue that old people were contributing 61billion to the economy through employment, informal caring and volunteering and that this amount was six times more than the money that was spent on social care by local authorities in the UK. There for older citizens contributed more to the economic than they use.in other words many older people spent their working lives contributing to the economy and build the welfare state, so suggesting that they are taking it away from young people is a misapprehension .
There for it is clear that many theories of ageing are a product of the social concerns of society. However, theories have informed government policies and they influence attitudes towards older people, as well as being influential in how older people feel about themselves.
An understanding of older people as an oppressed group has been growing steadily in recent years. A person’s age will often be a factor that plays a part in shaping their social location and the response of other social factors. Ageism often manifests itself as a set of stereotype assumption about what old people cannot or should not do.
Age discrimination continues to blight our society, despite a decade of government policies designed to address it. For older people age discrimination is associated with worse psychological well- being and poorer physical health outcomes. Ageism remains a major problem in the National Health Service, the very organisation intended to promote health and well-being.
Oliver, (1996) stated that old people perpetually experience discrimination and a degree of social exclusion. They have been systematically excluded from British society because of their age. The statistics in the UK can often hide the poverty and discrimination that old people face in their daily life. For example, many old people in the UK have been hit by cuts in public sectors funding and find that they are no longer eligible for many public services like meals on wheels (Tribe, 2017).
This combined with the rising costs of commodities, including food and utilities as well as poor life savings, means that many older people in the UK are now living in poverty. In addition, and those who contributed to private pensions are now finding that these have been devalued or their terms changed because of the economic crisis .
According to (Lister, 2007) the society looks at old people as people who drain the economy because they no longer contribute to the labour market or the production of wealth. This shows a failure to recognise the investment in the economy that old people have made over the years through their labour. In addition, many older carers are playing an important role in the economy by looking after grandchildren thereby giving the children’s parent the opportunity to work or caring for elderly or disabled relatives, which removes the need for public services.
There are lot of old people who are homeless and are more vulnerable to mental health concerns due to their experience of exclusion and discrimination. Looking back at Cumming and Henry (1961) Disengagement theory approach which suggested that older people should withdraw from their social roles to give young people opportunity to shape society. Disengagement theory use a systems approach to ageing and was concerned with the efficiency of the social and economic systems in society, suggest that old people had a moral obligation to disengage from society for the benefit of the social system. Many young people started to be consumers and creators of new products, gaining collective power and they started to rejects the values of the older generations .
By suggesting that old people should disengage from being active members of society, this theory in my view indirectly promotes age discrimination because it discourages old people to take up hobbies and other roles within society meaning they become isolated and lonely. This type of attitude will inevitably bring homelessness, depression and other forms of mental health problems for old people. This disengagement means older people are more likely to experience a drop in socioeconomic status. Such things often result in isolation, loneliness and psychological distress in older people, for which they may lead to further health problems (Who Health Organisation, 2017).a recent survey revealed that half of old people age 75 and over live alone and one in ten people age over 70 years admitted to being lonely, that is over a million old people in the UK (Which Publications, 2019).
Older people living in low-and middle income usually have little or no economic support from the state. In consequently they find themselves living in extreme poverty with limited access to health care or financial support (Shelter, 2018). According to Dwyer, (2011) the majority of older people living in high income have access to both a state pension and healthcare services. Although some older people from middle and high income professions have occupational pensions that are protected. Therefore, when considering the context of older people’s lives there are extreme discrimination between the rich and poor (Fernando, 2002).
Discrimination causes mental health problem such as depression, social anxiety disorder, panic disorder, post-traumatic stress. The sign of mental health is the change of behaviour like, withdrawal, isolation, losing interest in pleasurable activities, agitation, and tearfulness, lack of confidence, loss of motivation, loss of independence, becoming angry and being more forgetful (Who Health Organisation, 2017).
Clinical work with older people can be across a range of contexts and disciplines including nurses, doctors, social workers, occupational therapists, psychologists, and residential nurse, managers of care as well as families and carers. According to Wallcraft et al (2011), GPs refer patients to mental health services for a diagnosis or support from social care workers to provide help to staff and managers, to manage old adult’s behaviours and psychological symptoms of distress, from a range of mental health condition such as dementia and common mental health condition. GPs therefore play a vital role in the provision of care for old people and often become the source of information for other professionals as they tend to develop relationships with old people and these relationships can often be over decades long. The Disengagement theory structural social systems to blame for how well people age.
According to World Health Organization (2001) Mental health is more than simply an absence of symptoms of mental distress it involves a positive sense of well-being and ability to lead a full and productive life. This can often be affected by the presence of family and/or communion with others. Families play a vital role in the healthcare provision of old people, however families have often been known to be the source of controversy when it comes to the care of the elderly because the act of balancing their needs and the opinions of professionals often creates unhelpful disagreements in the decision making process in providing care (Which Publications, 2019).
Robert Havighurst, (1961) in Active ageing theory talks about the social values of our time and the way we view older people. It focusses on the productive potential of older as paid workers or volunteers and the need to look after the body. Living independently and maintaining social activities. It focuses also on the responsibility of individuals to look after their own health and well-being.it is worth pointing out that active theory may create different tension for old people , as it holds out the ideal of a successful and physically vital, where positive mental and physical health are idealised (Gates, 2007). Higgs and Gilleard (2013) suggested that active ageing is underpinned by new identity politics, as it implies that the individual should take more responsibility for their own health and that this is linked to the market and consumerism that encouraging older people to make lifestyle choices.
This theory in some other way create a stereotype where older people are seen as having a duty to stay fit. Discrimination come into when looking at this theory because if you look on television all you see is old people going into surgeries for the renewal of their youth as they fear to lose their jobs or being looked at as old. The theory also focus on the contribution of old people in the domains of work (Which Publications, 2019). The idea of active ageing creates a narrative that only legitimises very specific ways of growing old this excludes the lived experience of many old people, especially those living with a mental health or who are poor to make lifestyle choices (tew, 2015).
Carers are often the people who best know the people they are caring for, and they can provide valuable insight and information about the care needed by that person. Even though most practitioners do not look at carers as people who knows anything. However, Twigg, (2000) argues that old people in receipt of home care services are often at high risks of developing depression with estimate range from 24 to 44 per cent of users. Also home care workers often find themselves carrying the difficulties of working this area on their own. Home carers often become confidants for old people and therefore can reduce the effects of isolation and loneliness (Cancian, 2000).
The statistic shows that many carers of old people with mental health problems are their grown up children, spouse or life partners and they are usually old themselves and providing more than 40 to 50 hours a week of care this can have an impact on mental health. maintaining the well-being of a career is very important in enabling older people to remain in the community for as long as possible (Mind, 2013). Care Act, (2014) increased the attention paid to the needs of carers, although the report state that there is difficulties associated with the labelling ,accessibility and appropriateness of service may in fact result in carers not seeking help or recognising their own needs and rights to access services (Mohebati, 2012).
Evaluate the impact of socio/political contexts on social welfare policies around health social care and ageing.
The welfare system in the UK has always been based on helping poorer members of society to be able to afford basic necessities such as housing, education and healthcare. This led to the introduction of the Poor Law, which ensured that the poor were housed, clothed and fed. In addition, children would receive some form of free education (The National Archives, 2017). This has continued to be the case and the UK governments have continued to subsidise essential services such as health, housing, education and social care through governments departments such as NHS and department for work and pensions.
However, following a period of economic crisis in 2007-2008 social and political policies in the UK have been subject to the austerity measures that have seen the government cut back on public spending. This has had significant impact on health, social care and access to services to vulnerable groups such as old people.
One example of this has been the rise in the number of homeless people in the UK since 2008. It has been revealed that 320,000 people are reported as being homeless and this numbers is said to be increasing every day (Shelter, 2018). Homelessness has become a national crisis in cities like Liverpool where more and more people especially old people are sleeping on the streets. This has come about as a result of the changes in welfare policies such as the introduction of bedroom tax and benefit cuts.
The other impact that has come because of the recent welfare policy changes has been the increase in hospital waiting times. According to Independent News (2019), A&E department in England is getting worst. Statistic show that 84.4 per cent of patients are admitted 80.000 waiting over four hours for a bed to be found. Some of the patient are left in the corridors or on hospital trollies. The hospital overcrowding create risks of harm to the patients as well as death, because of the lack of staff.
Whilst the government have continued to put measures in place to improve waiting times, and in some cases impose fines on hospitals that fail to reach these targets. It has meant that some old people who have the financial capability now prefer to go private or go abroad for treatments and/or operations meaning that old people are no longer getting the full benefits of the health system they paid into. (Which Publications, 2019)
Demonstrate knowledge and understanding of contemporary policy and legislation in relation to health and social care for older people in England.
Equality act 2010 this Act brought a wide range of past anti-discrimination laws together under a single law to protect individuals from unfair treatment and to promote equality. It is a legislation, which was put forward regarding discrimination against people in education, employment or service provision in relation to age, disability, gender, marital status, race, religion belief and sexual orientation (thompson, 2006).
Under the Equality Act there is four types of discrimination; direct discrimination means that people are treated less favourable because of their age example a doctor refuses to treat an old patient simple because of their age. Indirect discrimination it occurs when the practices of an organisation or an individual apply to everyone but put certain people at a disadvantage. Victimisation this means treating other person bad because they have undertaken a protected act. Harassment this is defined as unwanted conduct and must be related to a protected characteristic or be of a sexual nature and can be verbal, physical or written (Tribe, 2017).
Mental capacity Act 2005 when someone is deemed to lack the mental capacity to make decisions and how this relates to the individual and their carer. It is common that old people with learning disabilities a being placed in a generic nursing home environment where staff lack skills, knowledge and attitude that required meeting their needs of such person (tew, 2015). Old people with learning disability have no choice about, where they want to live and their supported. Despite the fact that the families have voiced their concerns over the lack of planning for their loved ones. The Act stipulates clear evidence that individuals consent to decisions that affects their lives (Adam N, 2014).
Safeguarding legislation has established that neglect or failure to act where there is a known or suspected vulnerability are forms of abuse. Under UK, care Act (2014) the local authority has a duty to make enquiries where there is reasonable cause to suspect either that an adult with care and support needs is being abused or neglected or is at risk of being abused or neglected. Failure to include could be viewed as a failure to meet this requirement of (act Age UK 2016). Care act meet the needs of old people who are hard to reach and hard to engage because they are known to be vulnerable (Fernando, 2002). Thompson 2002 suggest that anti-discrimination practice is any form of action that tries to prevent the order from diversity to discrimination and to oppression.in the case of older people the difference is social isolation and the vulnerability of not having or not being able to summon or use the support networks of the majority of people can use.
The dynamic that leads older people from social isolation to social exclusion, homeless and mental health can change. It just requires proactive working to increase the inclusive of services. System change because people want to make that change and persist.by organising a community of practice between professionals and the communities working developing links with volunteers an charitable activity that will benefit older age to be able to connect, be active and take notice.