Around the world many are working on how we develop support for ageing populations. In South Korea they are looking to restructure jobs to make them more suitable for older workers. Brazil has established older people’s councils to consider the issues and generate ideas. The World Health Organisation has identified ten priorities towards making 2020-2030 a decade of health ageing. One of these priorities is sharing information and experience.
We all make mistakes. These will be of varying degrees and seriousness, but all of us can look back on judgements that proved to be wrong, decisions made in error or things we would, in hindsight, have done differently. Sometimes it may be that we just didn’t understand the impact of a particular factor or event. The same also applies to organisations. Neither good intentions nor past success provides immunity. Of course, the larger and more influential an organisation, the more the consequences of mistakes are likely to be magnified. Businesses may pay for these mistakes in terms of profit, share value or even their survival. We may want to ponder the consequences when health bodies make significant errors.
We all know there are many factors involved in any individual’s health, there are environmental factors, the physical circumstances in which they live, their behaviours and genetics. Access to good medical services, for both prevention and treatment are also recognised as being important. But the processes by which it is decided which services are provided where, be that at a national, regional or local level are, perhaps, less frequently considered. Yet we all know there are significant variations in everything from cancer survival rates (good to be in the USA, Canada, Australia, Finland or Iceland) to access to good quality ante-natal and early years care, where Western Europe general does well as do Japan, Singapore, Hong Kong and Macau but the USA does relatively badly.
I was recently involved in a visit to London by a group from Washington DC. They were drawn from the offices of both Republican and Democrat members, and all shared an interest in learning more about UK harm reduction approaches. While my contribution was limited to illegal drugs and alcohol, they also met those involved in promoting tobacco harm reduction approaches. I am always struck by how much more difficult and complex we make harm reduction around legal substances than illegal. Providing advice on how an injecting heroin user might reduce risks to themselves and those around them is, by and large, pretty uncontroversial. Start talking about offering practical advice to those who drink above the government recommended guidelines or to those who smoke or otherwise consume nicotine (despite the efforts of Public Health England), and you can quickly find yourself in hot water.