Managing an ageing population: Lessons the UK could learn from Cuba

• DOI: https://doi.org/10.13169/intejcubastud.14.1.0154
• Pages: 154-176
• Published date: 05 July 2022
• Date: 05 July 2022
• Author: Caroline Helen Jarman
• Subject Matter: UK,Cuba,elderly,ageing,care,health

InternatIonal Journal of Cuban StudIeS 14.1 Summer 2022

ACADEMIC ARTICLE

MANAGING AN AGEING POPULATION:

LESSONS THE UK COULD LEARN FROM

CUBA

Caroline Helen Jarman

King’s College London1

Abstract

Both the UK and Cuba face an ageing population, which presents major challenges for

their health and social care sectors. Although the UK is considerably more developed than

Cuba, its disorganised and inadequate community services for older people, combined

with a less preventative approach to the health of its older population have increased

pressure on care homes and hospitals alike. In contrast, Cuba’s cheaper, preventative

and holistic elderly care programme integrates health and social care to sufficiently

serve its older population. This article demonstrates the flaws in the UK elderly care

system and highlights the successes of the Cuban system, before formulating three

suggested areas of research for potential implementation in the UK based on Cuban

principles. These are: 1) associating care homes with medical professionals, 2)

overhauling the NHS health check system and 3) providing each local authority with a

1 Having read a degree in Biomedical Sciences at the University of Durham, Caroline

Jarman is now in her fourth year of studying Medicine at King’s College London.

She came to understand some of the health and social care challenges in managing

and caring for an ageing population whilst undertaking a clinical placement in Care

of the Elderly and whilst working as a care worker at a care home in Hertfordshire.

As a result, Caroline researched other approaches for how best to care for an age-

ing population, and she found the Cuban system to be extremely successful. Having

written her article, Caroline had planned to travel to Cuba over the summer of 2020.

Unfortunately, these plans were impeded by the COVID-19 pandemic. She hopes to

travel there when possible in the future.

DOI:10.13169/intejcubastud.14.1.0154

MANAGING AN AGEING POPULATION 155

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wider variety of facilities for the older person. Modelling Cuba’s elderly care system with

these suggestions may improve the management of an ageing population in the UK by

increasing disease prevention and care planning. This should improve the overall health

of the UK’s older population whilst saving the health service both money and time.

Key words: UK, Cuba, elderly, ageing, care, health

Introduction

The UK and Cuba both face an ageing population and associated challenges. By

2030, older people, defined as those aged over 65 years, are set to comprise 21.7%

of Cuba’s population (United Nations 2019), and 21.8% of the UK’s population

(Age UK 2019a). Despite their societal and cultural differences, both aim to care for

older people in the community for as long as possible and maintain their health to

minimise hospital admissions (Reed 2008; Age UK 2019b). However, attempts to

achieve these goals have had varying success. The UK’s inadequate community

services have contributed to overstretching care homes and hospitals, whilst Cuba’s

widespread, government-run elderly care programme has more levels to its system

and employs a disease-preventing approach. This article will highlight the flaws of

the elderly care system in the UK and discuss the successes of the Cuban system

before proposing suggested areas of research for implementation into the UK

elderly care system based on Cuban principles.

The Flaws of the UK Elderly Care System

The UK offers a relatively narrow range of community services for the older popula-

tion who live at home. As there is no centrally run programme coordinating the

delivery of these facilities, their availability varies dramatically between health

authorities, creating a postcode lottery. The provision of services for local communi-

ties is organised by Clinical Commissioning Groups (CCGs) formed of groups of

GPs (NHS England 2020a). As CCGs are totally separate from one another, the

commissioning of services is not coordinated across the UK, so care options for

elderly people vary greatly with location. For example, “meals on wheels”, an initia-

tive whereby people pay a small fee for meal deliveries, has reduced its service by

24% since 2014 as a result of a 47% spending cut (Mortimer and Green 2015;

National Association of Care Catering 2018). It is now offered by just 42% of

CCGs (National Association of Care Catering 2018). The CCGs also vary in size

dramatically, so residents of larger CCGs often encounter access issues. This is espe-

cially problematic for the 24.3% of over 65s who live in rural areas, where transport