There are only two phases in life, a phase of growth and development, a turning point, and then it's downhill all the way. But Ed, don't worry about that, because aging is only one of four processes taking place, and the first of these is loss of fitness. And Daniel Lieberman, who's a very clever professor at Harvard, said that this is not a lifestyle issue, it's an environmental issue. The genes that you have inherited from hundreds of generations. Favor being able to run about all the time, and if any calories are about, you put on fat as quickly as possible. We now live in a world in which inactivity is required of us. And I never use the word lifestyle. I mean, if you're commuting from Vauxhall to barking and sitting eight hours in front of a computer screen. You don't have a lot of lifestyle time to change things, but I am working with it with organizations. The computer should switch off every five every hour for five minutes, and they shouldn't go on again until you can show you done five minutes press walking. That's a pretty simple technology thing to solve, but it's a cultural change. So a fitness gap opens up the longer we live. The good news is that at any age you can close the fitness gap. Now, what do I mean by fitness? Well, it's a loss of maximum level of ability and a loss of resilience, just the same as aging, which is why everyone, including the medical profession has confused these two things until very recently. Now, fitness is sometimes helpful to think of five assets of fitness, strength, stamina, suppleness and skill. And what's the fifth? S, psychological pathetic aid, then you have disease. And most diseases are environmental in our origin. You need a bit of luck to avoid Alzheimer's, which is only 60 or 65% of dementia and Parkinson's, but diseases are environmental type two diabetes, high blood pressure, heart disease. These are mismatched diseases between our genome and the environment in which we live. Now what we see you after disease starts is that the fitness gap gets wider faster, and you may drop below what I call the line, the line, and that's the point at which you can't get the toilet in time. And that's it. Game over social care. Why does the fitness gap get wider faster? It's not because, well, there is a disease. I had a myocardial infarction 11 years ago. So that's a chunk of heart muscle, but the fitness gap gets wider faster because of attitudes of other people. The sun comes to see you from Middlesbrough and you say, Well, I'm fine. A bit difficult get the shops in summertime. So what does the sun do? Oh, Caddo. Oh, don't do that, Mum, we'll do it for you. We'll take we'll do things for you, well intentioned ageist approach, and that is, we need to look at this, because at any age, no matter how many conditions you've got, you can close the fitness gap. So the third factor is social factors. Far too many people are affected by deprivation, and all of us are affected by ageism, by negative thinking, well. And ageism is not all bad, is it? Well? I think it is. And hottest day of the year, and I'm counting the days till I get my next winter fuel pain. The government's going to give me 250 pounds because of my age, and I was not imprisoned for the whole of the week 18 to 24 September. Don't ask me. Don't ask me. But I'd like to ask all of you who are born before 25th then 1957 let's campaign against the winter fuel grant for everyone, I reckon it's a quarter of a billion pounds a year. There's a million people get this winter fuel allowance. That's a billion pounds over the next, the next four years, and the NHS asking for 30 billion pounds coming on the other half of my life is called the value in stewardship program, and 50% of all the money in the NHS is wasted. That's no good. That equals about 34 billion pounds. Supposing we gave a billion pounds to primary schools, children could have a decent meal liberty. And actually, I think you as older people, why don't you support your local primary school? I'll come back to that. So ladies and gentlemen, here are the facts of life. There are four things affecting us as we live longer, and we can influence all of them, understand aging, regain fitness, prevent attacks and take social action. Okay? Well, that's that's the talk, ladies and gentlemen, to the the club. Just checking my time here, this is one of the most useful things. Actually, is it they've been this, in my view, this will change medicine more than the genome, but that's that's a personal point of view. So let's just think what we're trying to achieve, and it's about living longer, better, compression of morbidity at the end of life. That's the key issue tied into that is the difference between the most and the least deprived sections of society, and it's large and growing, V North 0x two and Oxford o x4 for example. So these are the policy issues. How are we going to do this? We have to do this because this will save the NHS. You see the top diagram is what happens to many people at the moment, with multiple admissions in the last few years of life. But if you are able to increase, in care, your fitness, physical, cognitive and emotional, and reduce your risk of long term conditions. And have a bit of luck, you be admitted to hospital less often. And being admitted to hospital is a high risk issue for people in their 70s, 80s and 90s. It's called the de conditioning syndrome. About 10% of the muscle mass is lost in a week, very significant changes taking place. So how are we going to do this? Well, this is the century of the system in the network. And I have lived through 20 reorganizations of the NHS, most of which have made no difference at all. But here's the system that we've been developing. And I hope you're going to, I think you'd find this. I put this in the handout that I've given. These are the key thing is, is to have strategic objectives. That's what I've learned for the military. You need strategic objectives, and then you let local operational commanders take into account local history, geography and politics. So we don't tell people how to run the health service locally. We set the objectives. So just have a look at these. These are the objectives that we've developed in discussion with older people to reduce the risk of dementia, to enabling strengthening of purpose. And then that brought the foot of the list there to enable dying well, as well as living well. Every bridge club, every Bulls Club, every mosque, should be talking about dying well once a year, let's talk about it. It's not just a legal matter. It's something we need to talk about. And that is now starting to emerge and surround doing a great job with that. So these this is the system. Now, systems are delivered by networks. This is the sense of the system and the network. And a network, obviously consists of the local organizations, but we're also developing digital networks, which were great to get round glass involved in starting to bring together issues. Now, people immediately say rightly that not all older people are yet online, and I accept that, but I was told 50 years ago, when I started working on Aging, that old people will never use the telephone. You're wasting your time. You are trying to arrange this weekend telephone club for all the people, because all people won't use the telephone. Where's the same this thing called the internet. Remember Tim Berners Lee, when asked his ambition in 2000 said that no one would use the word the internet in 10 years time. I mean digital. We don't see an electric health service. We'll come to our electric health service, digital just part of it, part of it all. So it's just not going to happen. So developing networks now, just to show the sort of thing we're doing, this is the information I've had from the NHS in the last year about the drugs that I take for my heart disease and various other problems. And the next slide is going to show you how the information I've had about diet, exercise, depression in the last 11 years is my myocardial infarction.