Ready for Ageing? - Select Committee on Public Service and Demographic Change Contents


The House of Lords Committee on Public Service and Demographic Change, chaired by Lord Filkin, was set up on 29 May 2012 "to consider public service provision in the light of demographic change, and to make recommendations".

The main, though not the only, demographic change is the very significant increase in the older population of the United Kingdom now and over coming decades. Living longer and healthier lives is to be welcomed, but it increases the need for and cost of public services, as the Office for Budget Responsibility (OBR) set out in its Fiscal Sustainability Report, July 2012.

If current policies go unchanged, the OBR advises that the cost of public services will increase to unsustainable levels. We cannot borrow more, yet there is a limit to how much extra society is willing to pay in taxes. This forces us to consider wider ways to respond.

There have been official inquiries into aspects of this. What has been lacking is an overall consideration of the implications of demographic change and an ageing population, for publicly funded services, individuals and localities.

An ageing population will pose challenges and choices for individuals, families and government and requires a re-thinking of attitudes and expectations about work, retirement, savings and the welfare state.

It is also necessary to consider whether the services, funding and support for older people are ready and able to cope with this major change, and the efficacy of wider public services.

The Committee will look as far ahead as 2040, but will pay particular attention to the next 10-15 years.

We invite you to contribute written evidence to this inquiry by 1st September 2012.

The scope of the inquiry is wide-ranging, so respondents should select from the issues below according to interest and expertise.

The Committee is exploring the implications of an ageing society for public services[524] through the following six questions which it considers are fundamental. We invite you to address them.

(1)  Does our culture about age and its onset need to change, and if so, how?

(2)  Do our expectations and attitudes about work, savings, retirement and independence need to change, and if so, how?

(3)  Do the extent and nature of public services need to change? If so, how, and how should they be paid for?

(4)  Do we need to redesign and transform public services for these challenges? If so, how?

(5)  What should be done now and what practical actions are needed?

(6)  How can we stimulate national debate about these issues?

The appendix gives some background, but respondents should not be limited by this.


A. What challenges will an ageing population pose?

(1)  The population projections from the Office for National Statistics show the very significant growth of the older population, and there will be many social benefits from this. But the OBR's recent Fiscal Sustainability Report, July 2012, forecasts a worsening fiscal deficit as a consequence. Do these forecasts capture the challenges or underestimate them?

(2)  If life expectancy rises further but healthy or disability free life expectancy does not there will be costs for health and social care, for state pensions and for public sector pensions. Are these risks and costs adequately shared?

(3)  Raising productivity in the NHS and in public services generally is fundamental to coping with the immediate fiscal challenge. Do you think it will happen? If not, what are the implications for the coming demographic challenges?

(4)  What will an ageing society be like? What might this imply for individuals, families, and communities? What are the implications for individuals' capacity to work longer and live independent lives, and for productivity, competitiveness and inequality?

(5)  Do the additional fiscal deficits caused by an ageing society, the increased demand for services and better outcomes require a radical re-think by central and local government and the NHS to prepare and change to address them? What should be done?

B. What strategic choices need to be addressed?

(6)  There are many benefits from an ageing population, but growing public sector demands and a growing fiscal challenge are consequences too. If society will not accept substantial tax increases what are the big choices for what the state does and what individuals do? Who should pay for what?

(7)  The increasing cost of an ageing population could put great pressure on expenditure on other priorities and investment. Will free health services, improved social care and decent state pensions all be affordable? What are the choices?

(8)  We will be better off in the future but there will still be a need to re-shape our expectations and our welfare state for an ageing population. Which attitudes and expectations need to change about our welfare state, about retirement, the age of retirement and inheritance?

(9)  Do we need greater clarity about what the state will and will not fund for the future, and a more explicit contract between the state and individuals? What should this be?

(10)  Do the dates when the state pension age rises reflect these coming changes? Are the risks and costs of public sector pensions shared fairly between beneficiaries and taxpayers?

(11)  How might inter-generational fairness be achieved? If we need to encourage younger people to save more for their own retirement, their social care and their higher education, can they also pay more taxes for an ageing population?

(12)  How are countries with similar ageing populations adapting?

C. What reforms to public actions are needed?


(13)  The additional demands and fiscal challenges caused by an ageing society, plus dissatisfaction with current services and outcome, require all public services to change for the better. Is this recognised, is it happening, if not what must be done?

(14)  Fundamental service re-designs may be needed. What might be the principles behind such re-design and are there attitudinal, structural and cultural impediments to making them happen such as silo structures and budgets, lack of preventative actions?

(15)  Where is it important for the state to reduce demand or transform its actions? Should we look at where expenditure is high yet outcomes are poor such as the management of long term conditions?

(16)  Which preventive programmes are most needed? Could new funding mechanisms such as social impact bonds make this happen?

Older people

(17)  How good are current services for older people? Services for older people are highly fragmented and subject to unhelpful financial incentives. What evidence is there of good practice in resolving these issues in the UK or abroad?

(18)  How should labour markets, employment law and practices change to enable older people to work?

(19)  How might government best stimulate and regulate markets to respond to the varied risks faced by vulnerable elderly people? What are the limits to such markets?

(20)  How can public actions help extend individuals' health and independence in older age? How can voluntary and community actions contribute more? How should housing services change better to support independent older living?

(21)  Funding constraints have already squeezed the resources available to private providers of long term care and NHS geriatric care. There have been concerns about standards in all sectors. What more should be done to improve standards and public confidence?

D. What should be done now?

(22)  Addressing these challenges requires public debate about choices, attitudes, and expectations. How can this happen? How can the public be stimulated to address the likelihood that they will live longer?

(23)  What should central government and local government and the NHS be doing now to address these challenges?

(24)  Changes to state priorities and efficacy for the medium term should arguably be significant considerations in the next public spending round. Is this happening?

The deadline for written evidence is 1 September 2012.

524   Public services are defined broadly to encompass all publicly funded actions including welfare payments. The welfare state itself takes about 2/3 of public expenditure net of debt payments.  Back

previous page contents next page

© Parliamentary copyright 2013