The Leveson Centre for the Study of Ageing,
Spirituality and Social Policy
The Policy Challenges of Population
Ageing
Review of Leveson Paper Number 5 by Kenneth Howse,
Research Fellow, Institute of Ageing, Oxford
Published by the Leveson Centre for the Study of Ageing, Spirituality
and Social Policy, 2003
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For more than thirty years, demographers have been telling anyone
who would listen that increasing longevity has important implications
for every aspect of our lives. And yet it seems that we find ourselves
quite suddenly in a crisis usually referred to as "the ageing
population". For older people, there are imminent concerns about
the value of pensions and the provision of health and social care,
since mere longevity is a mixed blessing without a degree of material
security and an assurance of an acceptable quality of life in its
later stages. Many people in the more economically active sections
of the population perceive a threat of an increasing tax burden to
support not only those who have not yet entered work but also a rapidly
increasing number who have ceased to do paid work.
But even to describe the position in these terms is to take a viewpoint
on the phenomena. Definitions such as those above are not politically,
socially, economically - or ethically - neutral. Kenneth Howse's paper,
The Policy Challenges of Population Ageing, was commissioned by James
Woodward, the Director of the Leveson Centre, as a contribution to
the ongoing debate about the policy implications of population ageing
and was presented at a Leveson Centre seminar in July 2003.
In his paper, Howse creates a baseline of evidence drawn from a number
of sources. Many of these relate directly to the United Kingdom, but
there are also frequent comparisons with other countries and other
regions of the world. He does not take sides with those who see population
ageing as the single most important social policy driver, displacing,
for example, the immigration-race-asylum complex and national economic
factors. Nor does he side with those who see the figures as simply
requiring an updated social welfare system in order to meet social
needs. Accepting that both viewpoints have some validity, he interrogates
their bases in fact, offering both support and criticism of their
policy implications.
He devotes a chapter of his paper to the demographic questions before
moving on to consider, in a further chapter, the matter of income
in retirement (the "pensions" question). Here he takes issue
with policy papers in the UK, the OECD and the World Bank. The World
Bank's paper distinguishes three elements in pensions: saving, redistribution
and insurance, and one of its major concerns is that governments have
adopted or supported a "single pillar" system whereby all
three elements are conflated into a single pension. That paper has
a number of critics whom Howse also discusses. Ultimately, Howse is
more sanguine than some voices in the World Bank about the threat
of economic meltdown. He points to signs that the UK government has
already heeded the warning about a "single pillar" approach
and argues that our sophisticated economy and society have sufficient
flexibility and capacity to deal with what is nonetheless a complicated
and difficult situation.
In his chapter on Long Term Care, Howse addresses three principal
issues. These are "concern about the overall costs of future
provision; disagreement about the way these additional costs should
be distributed across the community; and concern about the present
unfairness of the system or its ability to cope with increased demand".
Here Howse critiques a recent study by the OECD that offers a fairly
upbeat assessment of the ability of advanced economies (i.e. OECD
countries in particular) to handle these difficulties. He uses data
from a variety of sources including a recent Royal Commission, the
Institute of Actuaries, the Personal Social Services Research Unit
(PSSRU) at the University of Kent and the Joseph Rowntree Foundation.
In a move that typifies the paper, he does not reach a single conclusion.
Instead, he prompts the reader to appreciate - even savour - the complexity
of the situation and to challenge his/her own "obvious"
solutions. This is most evident where Howse tackles the question of
the fairness of present and possible future policies about where the
responsibility for care lies. What, for example, is the responsibility
of an adult child who lives a hundred miles from his/her parents,
who needs to stay in employment to survive and to raise children and
yet has two ageing and perhaps disabled parents who may need care
for the next fifteen years? Slick answers will almost certainly be
unfair to someone.
The "generational contract" lies at the heart of Howse's
next chapter on Social Justice and Individual Wellbeing. There is
clear evidence that many older people get a raw deal compared with
other groups (although this cannot be separated from other factors
such as capitalist economics and class discrimations). That is why
Age Concern and Help the Aged are working together with a view to
"eliminating age discrimination in areas such as employment and
health care; promoting a more positive view of ageing; and empowering
older people to participate in society". His discussion of these
matters leads Howse on to discuss both healthy and active ageing and
to some "revolutionary thinking for an ageing society".
In his conclusion, Howse notes that "there is not a great deal
to be said about the challenges of population ageing that is uncontroversial.
Much of the disagreement turns on the matter of costs and their consequences
for the general direction of policy reform". A close reading
of this paper is likely to convince the reader of the truth of both
these statements. It is the quality of Howse's understanding of the
issues and his ability to communicate them clearly, fairly and succinctly
that leave the reader with a sense of gratitude to the writer.
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