“Make the most of your sixties” my sister told me “you’ll find your friends getting ill in their seventies”. And how true that is. I have friends in their sixties who have become ill but there is a reality about the number of people I know in their seventies who have one ailment or another, and sometimes several. It is unsettling, especially when one hears about how the NHS is already struggling. What will happen when we Baby Boomers move into our seventies and eighties? There are so many of us! Plus the population is expanding, putting even more pressure on doctors, hospitals, infrastructure. It leaves me feeling vulnerable. How will we receive care should we need it? Could Artificial Intelligence be the answer?
The problem few people talk about is demographics. Many of the senior consultants and doctors are the same age as I am – late sixties, coming up 70. They are retiring. Many doctors are retiring early because they take can’t take the pressure. This is not just a UK problem, it is world wide. After all, it was a World War 1939-45, so the Baby Boom occurred globally and that generation, my generation, are retiring not only from medicine but from senior positions in organisations of all kinds. And the numbers don’t add up – there are simply fewer people in the generation below, so the immediate problem cannot be remedied easily. All these political accusations being bandied about that “we just need to hire more doctors” aren’t realistic. Where will they get them from when there is a shortage of doctors not only in the UK but in Canada, France and elsewhere. You can’t train medics overnight. And immigration will only deprive other countries of this expertise.
This morning on Radio 4’s The Life Scientific we listened to Demis Hassabis, an expert in AI. He spoke of how his company has worked with Moorfields Hospital, who had a shortage of staff for optical scanning, whereby the computer system actually scans patient’s eyes more efficiently than human doctors. How marvellous. If we can provide a more effective service with the help of computer intelligence, let’s do it. After all, look how much more we understand about the human body since we have had X-rays, MRI and CAT scans.
I became interested in technological methods of care when my mother had a stroke back in 2001. She had an alarm she was supposed to wear around her neck, but of course she didn’t wear it at night so when she got out of bed to draw her curtains in the morning and collapsed on the floor she didn’t have it on her. And even if she had, she wouldn’t have been able to press it because she didn’t have the capacity. The stroke had damaged her ability to function.
The worry about collapsing on the floor, slipping and breaking a hip, having a heart attack or stroke when one is alone is a concern that affects many of us. These incidents are real – two of my mother’s friends experienced lying on a bathroom floor for 6 hours. My mother was lying on her bedroom floor for a similar period before we reached her. A horrible, cold, lonely and frightening experience.
After this I became aware of the vulnerability of living alone, as I was myself at the time, at any age. I started to worry about my sons, of university age, getting drunk and falling down the stairs on their own. I woke up to the fact that so many people are living alone. Problems can occur at any age. I knew of people in their 40s who had aneurysm or other unexpected events. How to protect someone without interfering in their independence?
I came up with the idea of what would now be known as an app but the technology wasn’t there then – that someone would simply press one key on their mobile phone and their relatives would know they were ok. If they didn’t press it there would be an escalating system to check whether they were ok. BT were developing wrist bands to monitor heart rate. There was talk of simple movement pad detection to be placed in bathrooms or beside kettles to set off an alarm if they weren’t used for several hours. Technology can help. In today’s world these apps do exist, thankfully, though could become yet more sophisticated and personal, and I am sure they will.
With Brexit there is talk of us losing the EU nationals who provide care, hospitality and support services but several of the EU nationals (incidentally who think we should just get on with Brexit!) I have spoken to over the last year resent the fact that all they hear is that if we leave the EU people are moaning that they “will lose their cleaners”. “Surely we are more than that” they say. And of course they are, as many immigrants to the UK are actually far better qualified than the jobs they end up doing.
And this high standard of education is another challenge for our ageing world as when someone has a degree, MBA, MSc, MA or PhD they are hardly likely to want to do menial jobs such as care. The world is already a more educated place and those of us who live in the more developed areas have leant on the help we have received from countries that were behind our curve. There are larger numbers of young people in Africa, the Middle East and Latin America. But with the world population becoming more educated and professionally qualified will they want to be cleaning up after our mess? We will need to look for different solutions. Could AI can help us?
So, as I look at turning 70 next year the reality of becoming part of this massive ageing statistic (through no fault of my own I should point out!) is a little daunting. The NHS is creaking but no party is brave enough to radically transform the way it operates. Blair, as a Labour PM, could have done it but didn’t. And so it continues to struggle and with the UK population due to hit 70 million in coming years how on earth will we manage to take care of people. The demographics don’t add up. See graph.
And so that is why, when my 8 year old granddaughter told me she was doing a robotics course, I said “brilliant darling, please come up with solutions to provide robots to cook, clean, get us out of the bath, pour us a G&T, talk to us as companions and make sure we comfortable in our old age and don’t end up lying on the floor with no one noticing…”
I sincerely hope that she does!
You are right Helen. At age 75+ most of us will have three degenerative diseases mostly affecting blood vessels, brain and skeletal systems. Cancer is coming along on the inside lane. There are likely to be multiple medications and one in 1 in 4 will be frail. AI may help us with precision diagnosis. But the need is for medical services to adapt to the changing demography and challenges -particularly general practice. These people if symptomatic do need a comprehensive review at least yearly with a competent doctor/nurse practitioner. If functioning well this is not necessary. Many of the early NHS retirees might like to come back to offer a sessional review of the symptomatic group. Information about other areas affecting health, such as loneliness can be picked out with a birthday questionnaire preceding the review. We do this at the Phoenix Surgery in Cirencester.30 minutes becomes available, instead of 10 minutes, The savings in drug costs and enhanced well-being is large as shown by the research. .