The headline figures are indeed stark with the IBR identifying a 40% potential increase in age related spending by 2057. However, we should view this figure with some caution. In particular other public spending will fall as result of the same demographics, reducing the net increase to around 10%. Then we should challenge the assumption that the disability ratio does not improve. In other words there is some evidence that we may be getting older, but we are also getting healthier and these may offset each other. For more on this read Remeasuring Aging by Warren Sanderson in Science magazine (September 2010).
My other concern is that demographic change is consistently portrayed as a crisis. I reflected on this after reading the January Holyrood Magazine supplement on older people. This used a particularly negative, and typically barking, Adam Smith Institute report on demographic change, followed by lots of articles on 'the crisis'.
Even if the headline statistics are true I can still see some positives from demographic change. Better health and wellbeing should be something to be welcomed, along with more economically active older people contributing to the economy and supporting their families. Informal care is just one example. Older people are also the core of the many local organisations that are at the centre of our communities. They bring not just their time, but a wealth of experience. In this context we should not treat older people simply as an item on a balance sheet.
Many of these benefits depend on better health in old age. Tom Kirkwood at Newcastle University's Institute for Ageing has done a lot on this. He highlights the importance of work design during working life and in particular the level of work autonomy. His emphasis on income equality reflects the Spirit Level (Wilkinson and Pickett) analysis, including the importance of better education. In addition he focuses on social cohesion using the example of the impact on the health of Russian citizens after the collapse of the Soviet Union.
All of this highlights the importance of us having a comprehensive older peoples strategy, including preventative spending, not just a care strategy. I have spent this morning drafting a submission to the Expert Panel on Scottish Labour's plan for a National Care Service. Plenty of questions for them to consider as there is with the Scottish Government's similar lead commissioning model. As yet we are not convinced that major organisational change is the right approach, but the debate is justified.
All we need to remember is that demographic change may not be as big a crisis as it at first appears and it could have some positives as well.