It has been difficult to avoid stories in the media about the problems facing the social care system, with local authorities such as Surrey and Bristol reporting the struggle they face with growing demand. But the impact of an increasingly elderly population is being felt in other areas too. The ONS have recently announced that dementia, fundamentally a disease of old age, has overtaken heart disease as the number one killer in the UK. The impact of these pressures on central government planning is evident – recent IFS (Figure 1) and OBR (Figure 2) fiscal analysis highlights how spending on health and pensions increasingly dominates central government expenditure.
These are major national challenges and suggest that it is probably time to ask again whether we need to revise our approach to Britain’s ageing population. Indeed, as a sign of things to come, the Government has appointed a ‘tsar’ to champion older workers. The last concerted attempt to look at ageing was a Lords Committee back in 2013 under the leadership of Lord Filkin. The Government response led to the setting up of a new What Works Centre for Ageing but otherwise looked more like a re-statement of pre-existing government policy rather than a bold new approach.
However, before we launch a new ageing strategy we need to ask ourselves hard questions about its purpose – what value will it add? The biggest issues that affect older people (i.e. health and income) are already getting lots of policy attention, and social care is steadily moving up the agenda. Would a new strategy simply react to fiscal challenges or is there something genuinely different to address, such as the conflicting pressures on older people’s time, or inter-generational fairness?
What can we learn from elsewhere?
A new approach would need to lead to genuine and lasting change. We have seen how this can work with the Pensions Commission - which has helped encourage saving for retirement and simplify the pensions system. An ageing strategy would need to focus on the key transitions in peoples’ lives, making significant connections between policy areas, and show where we need major shifts in roles and responsibilities.
Some other countries already take this more seriously, most noticeably Japan but also the US (which has a National Institute for Ageing) and the Republic of Ireland. The following extract is taken from Ireland’s strategy:
"…a society for all ages that celebrates and prepares properly for individual and population ageing. It will enable and support all ages and older people to enjoy physical and mental health and wellbeing to their full potential. It will promote and respect older people’s engagement in economic, social, cultural, community and family life, and foster better solidarity between generations. It will be a society in which the equality, independence, participation, care, self-fulfillment and dignity of older people are pursued at all times."
The role of research
Research has an important role to play, in both designing and evaluating policy. The English Longitudinal Study of Ageing (ELSA) is particularly significant as a dedicated resource for researchers in this area, and there are a wide range of publications that are already available. It has a large representative sample, follows people as they age and collects biomarkers. In Ireland, the ageing strategy is already underpinned with a dedicated set of indicators, including many that come from their equivalent to ELSA.
NatCen has been working with Independent Age and others to ensure our evidence from ELSA is organised in a way that aligns with the wishes of older people: living comfortably; contributing to society; getting the right care; and staying connected. We recently contributed to a study that looked at unmet social care need which made some clear policy recommendations for local governments.
There is a rich set of other surveys and evidence in the UK that could be turned to help in this task and are ready for mining. Understanding Society and the cohort studies (the participants of many of which are reaching later life now) can also be turned to this purpose. Indeed, Age UK has produced an index of well-being. Many of the cross-sectional studies are useful for tracking pensioners’ incomes and last year’s English Housing Survey included a special chapter on older people. Also, the Government Office for Science has produced a report on ageing.
It is a shame that it has needed a fiscal crisis to force us to think again about our approach to an ageing society. However, if this presents an opportunity, it should be taken and done right.