The Leveson Centre for the study of Ageing, Spirituality and Social Policy
The Policy Challenges of Population Ageing
Published by the Leveson Centre for the Study of Ageing, Spirituality
and Social Policy, 2003
Review of Leveson Paper Number 5 by Kenneth Howse,
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.
The Leveson Centre