Issue 2: March 2012

WHAT TO DO WITH SCOTLAND'S AGEING POPULATION?

By Charlie Jeffrey, Professor of Politics, University of Edinburgh

Universalism and Older People

The Scottish Parliament’s Finance Committee recently held an evidence session on the demographic challenges facing Scotland, in particular the challenge of Scotland’s ageing population.

A decade or so ago this challenge – essentially one of how to deal with more people living longer – conjured up lurid headlines of ‘demographic time bombs’. Having more older people living longer meant higher public spending on their pensions, their health care, their bus passes and, above all, Scotland’s gleaming new policy of free personal and nursing care.

The UK government had rejected free personal and nursing care on cost grounds, the Scottish government would reap the consequences of its profligacy. Paying for the growing needs of older people was argued to be simply unaffordable.

pressures have put the spotlight on 'universal' benefits like free personal and nursing care (or free university tuition for Scots, or free prescriptions or bus passes), not least in Crawford Beveridge's 2010 Independent Budget Review which raised question marks about the sustainability of universalism

Happily, successive Scottish governments have stuck to their guns. The pre-2007 Labour-Liberal Democrat coalition produced a strategy on older people and the challenges of an ageing population entitled ‘All Our Futures’. This set out an impressive vision of equal citizenship for older people: recognising the contributions to society older people had made and could continue to make, and recognising the obligations on the rest of us to enable their continued participation in society – including expensive policy interventions which enabled older people as far as possible to remain active in their homes and communities.

The SNP took forward that strategy after 2007 in a striking confirmation of that commitment to an equal citizenship, amongst other things producing extra funding for free personal and nursing care. But the SNP also has had to deal with the consequences in Scotland of the global financial crisis, in particular the pressures on public spending now pre-occupying John Swinney.

Those pressures have put the spotlight on ‘universal’ benefits like free personal and nursing care (or free university tuition for Scots, or free prescriptions or bus passes), not least in Crawford Beveridge’s 2010 Independent Budget Review which raised question marks about the sustainability of universalism.

The commitment to an active citizenship for older people has so far remained robust. We could easily have slipped back into ‘time bomb’ territory. But further debate looms. Two issues seem especially important.

The first is which is the group, if any, which should have a ‘universal’ benefit? We generally work around fixed age points – 60 or 65 – which once, but no longer, had to do with eligibility for state retirement benefits. But within the post-60/65 group there is enormous diversity. Many of our ‘younger old’ (broadly up to 75 years) are able and willing to work or carry out other unpaid roles in voluntary work or in family care. Many of our ‘older old’ (broadly over 85) have multiple disabilities requiring complex care; medical and therefore policy interventions. Older people in urban areas often have much better access to services than older people in rural areas. And some older people are pretty well off, while plenty of others have difficulty making ends meet.

though the projections of headline spending on free personal and nursing care are intimidating, that spending keeps many people out of more costly residential care, and much, much more costly hospital care

Does universalism really hold up amid such diversity? One way of answering that question – and one at the heart of current SNP policy – is to think of how much spending now on policies to support older people prevents later and more expensive interventions.

‘Preventative spending’ is an elusive but appealing concept. Its relevance to policies for older people is clear. Through their volunteering activities older people provide fabric for our communities; through their family care – especially looking after grandchildren – they enable others to be economically active. And though the projections of headline spending on free personal and nursing care are intimidating, that spending keeps many people out of more costly residential care, and much, much more costly hospital care.

So, how universalist do we want, or need to be? And how much do we, or can we, save in the future by spending preventatively now? The first of these questions is more one of principle, about what kind of society we aspire to. The second is much more about good data and evaluation to help us take a different, longer term view of how policies deliver outcomes. These are high stakes. Politics doesn’t often take a long term view. It needs to now.

 

Professor Charlie Jeffery is the Director of the University of Edinburgh Academy of Government

 

By Charlie Jeffrey, Professor of Politics, University of Edinburgh

Issue 2: March 2012

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