The Challenges of Ageing Populations: The Need for Societal Change

17/07/2013 17:26 BST | Updated 16/09/2013 10:12 BST

The issue of ageing populations in the UK (and other countries) is well known and much debated. However the causal factors associated with this phenomenon are not always well understood, involving, as they do, both:

• An unprecedented and continuing decline in all causes all ages mortality resulting in growing numbers of elderly (65+) and very elderly (80+) in the population

• a reduction in the numbers of children being born to families resulting in reduced fertility rate which are below the population replenishment level

The consequences of these two factors are a population bulge with increasing proportion of the population being economically inactive people and supported economically by a decreasing proportion of those who are economically active.

Neither are the implications of such changes always fully understood. While the impact on health and social care are well know there are also implications for many other areas of public policy.

While the issues surrounding the ageing population have been discussed for many years, it is relatively recently that a much-increased focus has been placed on them as a consequence of financial austerity. The state of the UK economy and public finances suggests that overall growth in public service spending may remain stagnant for the foreseeable future and hence, the challenges of the ageing population can no longer be assumed to be addressed by the fruits of economic growth. Issues such as the Barnet curve of doom have starkly illustrated the situation being faced in local government.

Many of the proposed approaches to the challenges of an ageing population involve what might be termed technocratic approaches. Technocratic denotes the application of technical means to areas where it is believed that cause and effect relationships are well established and technically rational action is possible. This might include such changes as: raising tax rates, postponing the state retirement age, releasing housing equity, increasing personal contributions, facilitating higher levels of immigration etc.

I believe the proponents of such technocratic approaches display a huge degree of naivety about the scale of the challenges involved and the likely effectiveness of the proposed measures. In my inaugural professorial lecture at Nottingham Business School in 2009, I coined the term "a social and economic watershed in our history" to describe the implications of the onset of prolonged financial austerity. In the light of this, I believe that we must consider potentially significant societal approaches as a response to the ageing population phenomenon. Societal approaches involve an alteration in the social order of a society and may include changes in the nature of; social institutions, social behaviours or social relations. This is sometimes referred to as social engineering - it is a term often used pejoratively but need not be so.

Some examples of such societal approaches (some of which are much more prevalent in other countries) include:

• Healthy ageing - among the elderly there is a wide range of variation in the loss of functionality and prevalence of disability. Healthy aging involves measures to promote healthier lifestyles among older people.

• Promotion of increased fertility rates - many countries have taken actions to raise their population fertility rates through various policies including financial incentives, enhanced child care etc.

• Increased family involvement in elderly social care - in some countries care of the elderly is seen as more of a family responsibility rather than a state responsibility. Policies to facilitate and encourage families to take greater responsibility might be considered.

• Alteration of the working life concept - the trend for many older people to work beyond 65 suggests that the pattern of working life may shift forward several years at both end of the range. This has considerable implications for younger people which need to be considered

Many of these societal approaches will be extremely unpopular in certain quarters and it sometimes seems "politically incorrect" to even discuss them in polite company. However, it is important that, as a society, we have an open debate their merits of such societal changes (and possible means of achievement) if only to rule them out as unachievable. In doing this, we must void the tendency for elitist groups in society stifle debate and to force their views on the majority.